Tobacco Use Disorder (TUD)

Tobacco Use Disorder (TUD)

• Tobacco use disorder occurs when a person craves, seeks, and uses tobacco, regardless of the consequences.
• This disorder can cause problems with mental and physical health.
• It can affect your ability to have healthy relationships, and it can keep you from meeting your responsibilities at work, home, or school.

Tobacco may be:

• Smoked as a cigarette or cigar.
• Inhaled using e-cigarettes.
• Smoked in a pipe or hookah.
• Chewed as smokeless tobacco.
• Inhaled into the nostrils as snuff.

Tobacco products contain a dangerous chemical called nicotine, which is very addictive. Nicotine triggers hormones that make the body feel stimulated and works on areas of the brain that make you feel good. These effects can make it hard for people to quit nicotine.

Tobacco contains many other unsafe chemicals that can damage almost every organ in the body. Smoking tobacco also puts others in danger due to fire risk and possible health problems caused by breathing in secondhand smoke.

What are the signs or symptoms of Tobacco Use Disorder?

Symptoms of TUD may include:

• Being unable to slow down or stop your tobacco use.
• Spending an abnormal amount of time getting or using tobacco.
• Craving tobacco. Cravings may last for up to 6 months after quitting.
• Tobacco use that:
  • Interferes with your work, school, or home life.
  • Interferes with your personal and social relationships.
  • Makes you give up activities that you once enjoyed or found important.
• Using tobacco even though you know that it is:
  • Dangerous or bad for your health or someone else’s health.
  • Causing problems in your life.
• Needing more and more of the substance to get the same effect (developing tolerance).
• Experiencing unpleasant symptoms if you do not use the substance (withdrawal). Withdrawal symptoms may include:
  • Depressed, anxious, or irritable mood.
  • Difficulty concentrating.
  • Increased appetite.
  • Restlessness or trouble sleeping.
• Using the substance to avoid withdrawal.

How is this diagnosed?

Tobacco Use Disorder may be diagnosed based on:

• Your current and past tobacco use. Your health care provider may ask questions about how your tobacco use affects your life.
• A physical exam.

You may be diagnosed with TUD if you have at least two symptoms within a 12-month period.

How is this treated?

Tobacco Use Disorder is treated by stopping tobacco use. Many people are unable to quit on their own and need help. Treatment may include:

• Nicotine replacement therapy (NRT). NRT provides nicotine without the other harmful chemicals in tobacco. NRT gradually lowers the dosage of nicotine in the body and reduces withdrawal symptoms. NRT is available as:
  • Over-the-counter gums, lozenges, and skin patches.
  • Prescription mouth inhalers and nasal sprays.
• Medicine that acts on the brain to reduce cravings and withdrawal symptoms.
• A type of talk therapy that examines your triggers for tobacco use, how to avoid them, and how to cope with cravings (behavioral therapy).
• Hypnosis. This may help with withdrawal symptoms.
• Joining a support group for others coping with TUD.

The best treatment for Tobacco Use Disorder is usually a combination of medicine, talk therapy, and support groups. Recovery can be a long process. Many people start using tobacco again after stopping (relapse). If you relapse, it does not mean that treatment will not work.

Follow these instructions at home:

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes.
• Avoid things that trigger tobacco use as much as you can. Triggers include people and situations that usually cause you to use tobacco.
• Avoid drinks that contain caffeine, including coffee. These may worsen some withdrawal symptoms.
• Find ways to manage stress. Wanting to smoke may cause stress, and stress can make you want to smoke. Relaxation techniques such as deep breathing, meditation, and yoga may help.
• Attend support groups as needed. These groups are an important part of long-term recovery for many people.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Check with your health care provider before taking any new prescription or over-the-counter medicines.
• Decide on a friend, family member, or smoking quit-line (such as 1-800-QUIT-NOW in the U.S.) that you can call or text when you feel the urge to smoke or when you need help coping with cravings.
• Keep all follow-up visits as told by your health care provider and therapist. This is important.

Contact a health care provider if:

• You are not able to take your medicines as prescribed.
• Your symptoms get worse, even with treatment.

Summary

• Tobacco use disorder (TUD) occurs when a person craves, seeks, and uses tobacco regardless of the consequences.
• Tobacco Use Disorder may be diagnosed based on your current and past tobacco use and a physical exam.
• Many people are unable to quit on their own and need help. Recovery can be a long process.
• The most effective treatment for Tobacco Use Disorder is usually a combination of medicine, talk therapy, and support groups.