6C4A.2

ICD-11 MMS 2026-01

Nicotine dependence

Description

Nicotine dependence is a disorder of regulation of nicotine use arising from repeated or continuous use of nicotine. The characteristic feature is a strong internal drive to use nicotine, which is manifested by impaired ability to control use, increasing priority given to use over other activities and persistence of use despite harm or negative consequences. These experiences are often accompanied by a subjective sensation of urge or craving to use nicotine. Physiological features of dependence may also be present, including tolerance to the effects of nicotine, withdrawal symptoms following cessation or reduction in use of nicotine, or repeated use of nicotine or pharmacologically similar substances to prevent or alleviate withdrawal symptoms. The features of dependence are usually evident over a period of at least 12 months but the diagnosis may be made if nicotine use is continuous (daily or almost daily) for at least 3 months.

Excludes

  • 6C4A.0 – Episode of harmful use of nicotine
  • 6C4A.1 – Harmful pattern of use of nicotine

Exclusions from above levels

  • QE62 – Uncomplicated bereavement
  • QE84 – Acute stress reaction

Child codes

  • 6C4A.20 – Nicotine dependence, current use
  • 6C4A.21 – Nicotine dependence, early full remission
  • 6C4A.22 – Nicotine dependence, sustained partial remission
  • 6C4A.23 – Nicotine dependence, sustained full remission
  • 6C4A.2Z – Nicotine dependence, unspecified

Sibling codes

  • 6C4A.0 – Episode of harmful use of nicotine
  • 6C4A.1 – Harmful pattern of use of nicotine
  • 6C4A.3 – Nicotine intoxication
  • 6C4A.4 – Nicotine withdrawal
  • 6C4A.Y – Other specified disorders due to use of nicotine
  • 6C4A.Z – Disorders due to use of nicotine, unspecified

Foundation entity

Nicotine dependence – http://id.who.int/icd/entity/1699574100

Allowed postcoordination axes

Part of: 6C4A: Disorders due to use of nicotine › 06: Mental, behavioural or neurodevelopmental disorders