In both writing and speaking, I have struggled with an awkward issue regarding using the words
“tobacco” and “nicotine.” The official term used in the current Diagnostic and Statistical Manual of Mental Health Disorders – Fifth Edith (DSM-5) [DSM] is “Tobacco Use Disorder.” This made sense when DSM-5 was released in 2013 because tobacco was the only widespread option for the intake of nicotine. However, with the development of tobacco-free electronic cigarettes and, more recently, oral nicotine pouches, a growing number of people who do not use tobacco are nevertheless developing problems with nicotine.
This evolution toward tobacco-free nicotine products is reflected, however, in the other standard diagnostic reference text – the World Health Organization’s International Classification of Diseases (ICD). The revision in current use in this country is ICD-10 and uses the outdated nomenclature of “Nicotine Dependence.” A newer revision (ICD-11), released in 2022 but not yet adopted by this country, updates the diagnostic language to “disorders due to use of nicotine” and has a specific code for vaping-related disorders.
Not being one to argue with the World Health Organization and wishing to simplify my language, going forward I will use the term “Nicotine Use Disorder” with the hope that the hope the ICD-11 will eventually become the standard revision in the U.S. and that the DSM will eventually follow suit.
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