Table 2.

Criteria for Substance (Nicotine) Dependence based on the Diagnostic Statistical Manual Version IV and the International Classification of Diseases Revision 10

DSM-IV	ICD-10
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifest by three (or more) of the following, occurring at any time in the same 12-month period
□Tolerance—need increased amounts of substance to achieve desired effect, or diminished effect with continued use of same amount	□Increased tolerance
□Withdrawal	□Sometimes, physical withdrawal
□Substance often taken in larger amounts or over a longer period than intended	□A strong desire to take the drug
□Persistent or unsuccessful efforts to cut down or control substance use	□Difficulty controlling use
□Great deal of time spent in activities necessary to obtain the substance or recover from its effects
□Important social, occupational, or recreational activities given up or reduced because of substance use	□Higher priority given to drug use than to other activities and obligations
□Substance use continued despite knowledge of having a persistent or recurrent physical or psychological problem likely to have been caused or exacerbated by the substance	□Persisting use despite harmful consequences

SOURCE: Adapted from Royal College of Physicians of London, 2000, Reference #(151)