Treating professionals such as psychiatrists, psychologists, psychotherapists, social workers and addiction counselors rely on criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) to diagnose substance dependence.
These criteria apply to all addictive substances (e.g., alcohol, opioids, cannabis, amphetamines), including nicotine and can be grouped into four categories that conveniently begin with the letter "C."
- Compulsion--the intensity with which the desire to use a chemical overwhelms the patient's thoughts, feelings and judgment.
- Control--the degree to which patients can (or cannot) control their chemical use once they have started using.
- Cutting down--the effects of reducing chemical intake; withdrawal symptoms.
- Consequences--denial or acceptance of the damage caused by the chemical.
The four Cs test can be used to assess a person's dependence on nicotine. You can assess yourself by looking over these questions and writing down your answers. Bring those answers to your treating professional, and help yourself get to your goal of Nicotine Freedom more quickly.
Assessing Nicotine Addiction Using the "Four Cs" Test
Compulsion
Do you ever smoke more than you intend?
Have you ever neglected a responsibility because you were smoking, or so you could smoke?
Control
Have you felt the need to control how much you smoke but were unable to do so easily?
Have you ever promised that you would quit smoking and bought a pack of cigarettes that same day?
Cutting down (and withdrawal symptoms)
Have you ever tried to stop smoking? How many times? For how long?
Have you ever had any of the following symptoms when you went for a while without a cigarette: agitation, difficulty concentrating, irritability, mood swings? If so, did the symptom go away after you smoked a cigarette?
Consequences
How long have you known that smoking was hurting your body? If you continue to smoke, how long do you expect to live? If you were able to quit smoking today and never start again, how long do you think you might live?