THE STUDY by Breslau et al1 in this issue is a striking example of the importance of determining nicotine dependence in studies on tobacco use. Nicotine dependence is in some respects an anomaly among psychiatric disorders. It is a condition cited and discussed often by the media, Congress, and the lay public. In fact, the lay public tends to overuse the diagnosis, assuming that all daily smokers are nicotine dependent.2 Psychiatrists, on the other hand, rarely cite it and underuse the diagnosis, failing to include it in structured research interviews, discussions about drug abuse, or problem lists of patients who smoke.3 The study by Breslau et al provides an important example of misinterpretations that can occur if one ignores nicotine dependence.
Hughes JR. Distinguishing Nicotine Dependence From Smoking: Why It Matters to Tobacco Control and Psychiatry. Arch Gen Psychiatry. 2001;58(9):817–818. doi:10.1001/archpsyc.58.9.817
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