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Tobacco is an addiction
It's time
Tobacco is an addiction
The New ASAM Criteria DSM
Author: Dr David Mee-Lee

Synopsis: ASAM (American Society of Addiction Medicine) is a professional society representing over 3,000 physicians and associated professionals dedicated to increasing access and improving the quality of addiction treatment; educating physicians, other medical professionals and the public; supporting research and prevention; and promoting the appropriate role of physicians in the care of patients with addictions. The ASAM criteria have become the most widely used and comprehensive set of guidelines for placement, continued stay and transfer/discharge of patients with addiction and co-occurring conditions. The ASAM criteria are required in over 30 states.

In the most recent edition, the criteria identifies Tobacco Use disorder as a problematic pattern of tobacco use leading to clinically significant impairment or distress.
Tobacco Use Disorder
A problematic pattern of tobacco use leading to clinically significant impairment or distress.
Individual meets two or more of the following criteria for tobacco use within a 12 month
  1. Tobacco is often taken in larger amounts or over a longer period than was intended.
  2. There is a persistent desire or unsuccessful efforts to cut down or control tobacco use.
  3. A great deal of time is spent in activities necessary to obtain tobacco, use tobacco, or recover from tobacco’s effects.
  4. Craving or a strong desire or urge to use tobacco.
  5. Recurrent tobacco use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., interference with work).
  6. Continued tobacco use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of tobacco. (e.g., arguments with others about tobacco use).
  7. Important social, occupational, or recreational activities are given up or reduced because of tobacco use.
  8. Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco.


Tolerance, as defined by either of the following:
  • A need for markedly increased amounts of tobacco to achieve intoxication or desired effect.
  • A markedly diminished effect with continued use of the same amount of tobacco.
Withdrawal, as manifested by either of the following:
  • The characteristic withdrawal syndrome for tobacco (refer to Criteria A and B of The Criteria sets for tobacco withdrawal)
  • Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms.

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