Nicotine use disorder

Nicotine use disorder is a pattern of nicotine use that leads to dependence, withdrawal and continued use despite harm.

Nicotine, whether from cigarettes, vaping products, smokeless tobacco or pouches, acts on receptors in the brain's reward pathways and produces rapid dependence. Features include cravings, using more than intended, unsuccessful attempts to cut down, and withdrawal symptoms such as irritability, anxiety, difficulty concentrating and increased appetite when use stops. The disorder affects adults and adolescents and is the leading preventable cause of disease in many countries.

Assessment uses a clinical interview and tools such as the Fagerström test, which gauges how soon after waking a person uses nicotine and how much. Established approaches include counseling, nicotine replacement and prescription medications. Cannabidiol has been examined in small early studies related to cigarette craving, and there is no approved use of cannabinoids for nicotine dependence.