What is tobacco use disorder?

Quick Answer
Tobacco use disorder occurs when the use of tobacco harms a person’s health or social functioning, or when a person becomes dependent on the nicotine in tobacco. Tobacco may be consumed in the form of cigarettes, smokeless tobacco products (including snuff and chewing tobacco), cigars, or pipes. This condition can be treated.
Expert Answers
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Tobacco products contain nicotine, which is transported to the brain and causes pleasurable sensations. The effects of nicotine dissipate within a few minutes, however. This causes tobacco users to continue using tobacco to maintain the pleasurable effects and prevent withdrawal. Other chemicals in tobacco products may also contribute to tobacco use disorder.

Risk Factors

There are many risk factors that increase the chance of developing tobacco use disorder, or nicotine addiction. Some risk factors are schizophrenia, post-traumatic stress disorder, bipolar disorder, major depression, and other mental illnesses.


Symptoms related to tobacco use disorder include nicotine “highs,” which are caused by an increase in blood pressure, blood sugar level, breathing rate, and heart rate. Symptoms of nicotine withdrawal include irritability, cravings, sleeplessness, increased appetite, nervousness, and headaches. Tobacco-related health problems may include smoker’s cough and hot flashes in women. Throat cancer is also strongly associated with tobacco use disorder. There are other consequences of tobacco use disorder as well, such as cancers of the larynx (voice box), oral cavity, throat, esophagus, lung, and colon; chronic bronchitis; emphysema; chronic obstructive pulmonary disease; heart disease; stroke; dementia; and miscarriage or premature delivery.

Screening and Diagnosis

A diagnosis of tobacco use disorder will involve a doctor inquiring about symptoms and medical history, as well as a physical examination and lung function tests. Doctors will typically ask questions pertaining to the duration and the frequency of tobacco use.

Treatment and Therapy

Treatment may consist of nicotine replacement therapy (NRT) and behavioral therapy. Nicotine replacement therapy (NRT) is used to relieve nicotine withdrawal symptoms. Examples of NRT products are nicotine gum, lozenges, nasal sprays, patches, and inhalers. Sometimes these products are used in combination, which may help some people stay smoke-free. Since NRT does not produce the pleasurable effects of tobacco, there is little chance that these products will be abused. According to various studies, NRT may help reduce the amount of tobacco consumed and help to control withdrawal symptoms after a person has quit smoking. NRT will also help smokers abstain from smoking.

Combining behavioral therapy with NRT may be even more helpful. Behavioral therapies are comprised of counseling, group behavior therapy, self-help classes and manuals, and text messaging programs. There is also cognitive-behavioral therapy, which teaches people to recognize high-risk tobacco situations, develop coping strategies, manage stress, improve problem-solving skills, and increase social support.

Certain medicines, such as some antidepressants, may help individuals quit smoking. Some medicines may help ease withdrawal symptoms and block nicotine effects if the person were to start smoking again. One side effect, however, is that these medicines may increase the risk of serious behavior changes.


The best prevention is to never use tobacco products, as they are very addictive. One should also stay away from places where people are smoking to avoid harmful exposure to secondhand smoke.


Anderson, Judith. It’s Your Health: Smoking. North Mankato: Smart Apple Media, 2005. Print.

Erickson, Carlton. The Science of Addiction: From Neurobiology to Treatment. New York: Norton, 2006. Print.

How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Rockville: US DHHS, 2010. Print.