Disorders due to use of nicotine

Disorders Due to Use of Nicotine are characterized by the pattern and consequences of nicotine use. Nicotine is the active dependence-producing constituent of the tobacco plant, Nicotiana tabacum. Nicotine is used overwhelmingly through smoking cigarettes. Increasingly, it is also used in electronic cigarettes that vaporize nicotine dissolved in a carrier solvent for inhalation (i.e., ‘vaping’). Pipe smoking, chewing tobacco and inhaling snuff are minor forms of use. Nicotine is a highly potent addictive compound and is the third most common psychoactive substance used worldwide after caffeine and alcohol. Nicotine Dependence and Nicotine Withdrawal are well described and Nicotine-Induced Mental Disorders are recognized. Tobacco, due to its addictive constituent nicotine, is by far the most important cause worldwide of morbidity and mortality of all the psychoactive substances and this is due in part to nicotine but more so to other constituents such as carcinogens and other hazardous and harmful compounds that are inhaled during smoking. Tobacco smoking is the leading cause of ill health and premature death among men and among the top ten causes in women.

Diagnostic Categories that Apply to Nicotine

Following is a list of specific diagnostic categories of that apply to nicotine:

• 6C4A.0 Episode of Harmful Use of Nicotine
• 6C4A.1 Harmful Pattern of Use of Nicotine
• 6C4A.2 Nicotine Dependence
• 6C4A.3 Nicotine Intoxication
• 6C4A.4 Nicotine Withdrawal
• 6C4A.Y Other Specified Disorder Due to Use of Nicotine
• 6C4A.Z Disorder Due to Use of Nicotine, Unspecified

The first three diagnoses listed above (Episode of Harmful Use of Nicotine, Harmful Pattern of Use of Nicotine, and Nicotine Dependence) describe the pattern of nicotine use. One of these three diagnoses, or Disorder Due to Use of Nicotine, Unspecified, for cases in which the use pattern in unknown at the time of evaluation, is considered to be the primary diagnosis. That is, one of these four diagnoses should be assigned when making a diagnosis of a Disorder Due to Nicotine Use.

The remaining diagnoses reflect the impact of the pattern of nicotine use and are thus considered to be associated with one of the primary use pattern diagnoses. These diagnoses should therefore be assigned together with the relevant primary diagnosis. For example, 6C4A.1/ 6C4A.4 is Harmful Pattern of Use of Nicotine associated with Nicotine Withdrawal, 6C4Z/6C4A.3 is Disorders Due to Substance Use, Unspecified associated with Nicotine Intoxication (i.e., the pattern of use in this last case is unknown).