In simple words: Nicotine dependence means you can't stop using tobacco, even though you know it's bad for you. This includes things like cigarettes, chewing tobacco, and e-cigarettes.You feel physical or mental symptoms if you try to quit.

Nicotine dependence, also known as tobacco dependence, refers to the inability to stop using tobacco products, which contain nicotine, even though aware of its harmful effects with physical and/or mental symptoms upon abrupt withdrawal of the substance. The provider does not document whether the dependence is on cigarettes, chewing tobacco, or other tobacco products or whether the dependence is in remission, withdrawal, or complicated by other nicotine–induced disorders.

Example 1: A 45-year-old patient reports smoking a pack of cigarettes a day for 20 years and expresses a desire to quit but finds themselves unable to do so despite multiple attempts., A 25-year-old patient presents with symptoms of anxiety and irritability after attempting to quit vaping. They admit to regular nicotine vaping for several years., A 60-year-old patient with a history of chewing tobacco use is experiencing difficulty concentrating and has increased appetite after attempting to stop using it.

Documentation should include: type of tobacco product used (cigarettes, e-cigarettes, chewing tobacco, etc.), frequency and duration of use, history of previous quit attempts, presence and severity of withdrawal symptoms, and any other nicotine-induced disorders.