Diagnosis and Treatment of Nicotine Addiction

Addiction to Nicotine and Tobacco is a Global Problem

Over the last thirty years the number of smokers aged 16 or over in Austria has remained stable; whereas the percentage of male smokers is declining, the rate of smoking among women is rising (27.5% male smokers vs. 19.4% female smokers) (Statistik Austria, 2007). 

Smoking is now recognised as a global health problem, affecting an estimated 1.1 billion people (George, 2007). With the introduction of the international classification of mental disorders ICD-10 (Dilling, Mombour & Schmidt, 1994) nicotine use was recognised as an addictive disorder in its own right. The addictive potential of cigarettes is comparable to that of “hard drugs” such as heroin or cocaine (Antony et al., 2000). Nicotine dependence can develop very quickly and it is extremely difficult to give up smoking. Symptoms of addiction and nicotine withdrawal often set in after only a few packets of cigarettes (Fidler et al., 2006). The problem is aggravated by the fact that cigarettes are so easily available.

Signs of Nicotine Dependence

Nicotine addiction or tobacco use disorder as defined by DSM-5 (American Psychiatric Association, 2015)
A problematic pattern of tobacco use leads to clinically significant impairments or ailments and at least two of the following criteria  must be met within a 12 month period:
  1. Tobacco is often used in larger amounts or over longer periods of time.
  2. Persistent desire or unsuccessful efforts to cut down or control use.
  3. A great deal of time is spent on activities necessary to obtain or use tobacco.
  4. Craving or a strong desire or urge to use tobacco.
  5. Recurrent tobacco use resulting in a failure to fulfil major role obligations at work, school, or home (e.g. obstructing work).
  6. Continued tobacco use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of tobacco (e.g. arguments with others about tobacco use).
  7. Important social, occupational or recreational activities are given up or reduced because of tobacco use.
  8. Recurrent tobacco use in situations in which it is physically hazardous (e.g. smoking in bed).
  9. Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco.
  10. Tolerance as defined by one of the following criteria:
    The need for markedly increased amounts of tobacco to achieve the desired effect.
    Markedly diminished effect with continued use of the same amount of tobacco.
  11. Withdrawal symptoms (irritability, anxiety, nervousness, increased appetite, ...) or tobacco (or a very similar substance like nicotine) is used to relieve or avoid withdrawal symptoms.

Non-Smoker at Last – Quitting Smoking

After even just an abstinence of several hours, many smokers develop physical withdrawal symptoms that are defined in the Diagnostic and Statistical Manual of Mental Disorders – DSM IV as a craving for tobacco, increased irritability, reduced frustration toleration, feeling tense or depressed, annoyance, aggression, anxiety, lack of concentration, restlessness, decreased heart rate, insomnia, and increased appetite (Heinz, 2003). However, these withdrawal symptoms do not always occur and it is possible to support smokers who wish to quit with medications in a therapeutic setting.
The Anton Proksch Institute Vienna helps smokers who wish to become non-smokers.
It offers a well-developed and established course of treatment that can help you stop smoking with a programme that includes behavioural therapy and medical support. You can take part in our programme while staying with us.

Therapy Programme