Association Between Cigarette Smoking Frequency and Tobacco Use Disorder in U.S. Adults

Abstract

Cigarette smoking remains a major cause of premature death and nicotine dependence is a major barrier to smoking cessation. 1 WHO. WHO report on the global tobacco epidemic 2017: monitoring tobacco use and prevention policies. WHO, Geneva, SwitzerlandPublished July 19, 2017https://www.who.int/tobacco/global_report/2017/en/Date accessed: November 12, 2020 Google Scholar ,2 HHSThe health consequences of smoking—50 years of progress: a report of the Surgeon General. HHS, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GAPublished January 2014https://www.ncbi.nlm.nih.gov/books/NBK179276/pdf/Bookshelf_NBK179276.pdfDate accessed: November 12, 2020 Google Scholar The DSM-5 is the primary guide to psychiatric diagnoses in the U.S. The 5th revision, released in 2013, replaced the term nicotine dependence and instead assigns the diagnosis tobacco use disorder (TUD) to individuals experiencing clinically significant impairment, as indicated by meeting at least 2 of 11 specified criteria. 3 American Psychiatric AssociationDiagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publishing, Washington, DC2013https://doi.org/10.1007/springerreference_179660 Crossref Google Scholar Clinical practice guidelines encourage clinicians to routinely assess and treat tobacco use and dependence. 4 Treating tobacco use and dependence: 2008 update. Agency for Healthcare Research and Quality. Updated February 2020https://www.ahrq.gov/prevention/guidelines/tobacco/index.htmlDate accessed: November 12, 2020 Google Scholar Patient's self-reported smoking rate is often used to guide clinical decision making, but surprisingly, no previous report has described the proportion of cigarette smokers who meet DSM-5 TUD criteria across the full range of cigarette use patterns in a representative sample of the U.S. population. Lighter smoking is frequently perceived as less harmful. Consequently, such smokers may be less likely to be identified by medical providers and less likely to receive appropriate treatment. 5 Schane RE Glantz SA Ling PM. Nondaily and social smoking: an increasingly prevalent pattern. Arch Intern Med. 2009; 169: 1742-1744https://doi.org/10.1001/archinternmed.2009.315 Crossref PubMed Scopus (135) Google Scholar Information on the true prevalence of TUD in this population can directly inform clinical practice.