Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision Substance-Related Disorders > Introduction > Nicotine-Related Disorders > Nicotine-Induced Disorder > 292.0 Nicotine Withdrawal Topics Discussed: nicotine withdrawal; smoking cessation; tobacco use cessation. Excerpt: "Refer, in addition, to the text and criteria for Substance Withdrawal (see Substance Withdrawal). The essential feature of Nicotine Withdrawal is the presence of a characteristic withdrawal syndrome that develops after the abrupt cessation of, or reduction in, the use of nicotine-containing products following a prolonged period (at least several weeks) of daily use (Criteria A and B). The withdrawal syndrome includes four or more of the following: dysphoric or depressed mood; insomnia; irritability, frustration, or anger; anxiety; difficulty concentrating; restlessness or impatience; decreased heart rate; and increased appetite or weight gain. The withdrawal symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion C). The symptoms must not be due to a general medical condition and are not better accounted for by another mental disorder (Criterion D).These symptoms are in large part due to nicotine deprivation and are typically more intense among individuals who smoke cigarettes than among individuals who use other nicotine-containing products. The more rapid onset of nicotine effects with cigarette smoking leads to a more intensive use pattern that is more difficult to give up because of the frequency and rapidity of reinforcement and the greater physical dependence on nicotine. In individuals who smoke cigarettes, heart rate decreases by 5 to 12 beats per minute in the first few days after stopping smoking, and weight increases an average of 2–3 kg over the first year after stopping smoking. Mild symptoms of withdrawal may occur after switching to low-tar/nicotine cigarettes and after stopping the use of smokeless (chewing) tobacco, nicotine gum, or nicotine patches...." DOI: 10.1176/appi.books.9780890423349.1625 The content above is only an excerpt. For full access subscribe now or log into your account below. You can also purchase 24- or 48-hour access; learn more Username: Password:     Athens Login FORGOT your subscriber username and/or password? Get a reminder via email: The email I registered with is:  Not a subscriber? Subscribe Today PsychiatryOnline is a powerful website that features DSM-IV-TR® and The American Journal of Psychiatry as the cornerstones of an unsurpassed collection of psychiatric references, including books, journals, and self-assessment tools. PsychiatryOnline’s innovative platform makes these resources easy and convenient to use, offering Precise and powerful searching across books and journals. Quick pathways to related material. Mobile access from any computer with a Web connection. Ability to download any book section to PDA. Links from bibliographic references to the full text of journal articles. References to material not located in the PsychiatryOnline collection lead you to PubMed. Learn more about PsychiatryOnline Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).