Is vaping considered tobacco use disorder?

September 27, 2025 •

3 min read

According to the National Institute on Drug Abuse, both tobacco and vaping devices contain the highly addictive chemical nicotine. This dependence on nicotine, regardless of its delivery method, is the key factor in determining if vaping is considered tobacco use disorder under current diagnostic criteria.

Quick Summary

Vaping with nicotine can be classified as a tobacco use disorder according to the DSM-5 criteria, as the diagnosis is based on nicotine dependence, not the specific product used. Clinically significant impairment or distress from nicotine use, even from e-cigarettes, is the defining factor.

Key Points

DSM-5 Classification: Under the latest diagnostic manual (DSM-5-TR), nicotine addiction from vaping is categorized as a tobacco use disorder, despite not involving combustible tobacco.
Dependence is the Key Factor: The diagnosis is not based on the product (vape vs. cigarette) but on the user's dependence on the substance, nicotine, and how it impacts their life.
Higher Addictive Potential: Some studies suggest vaping, especially in young adults, may be more addictive than traditional cigarettes due to higher nicotine concentrations and ease of use.
Mental Health Risks: Vaping can worsen symptoms of anxiety and depression and disrupt sleep and concentration, often creating a cycle of using nicotine to cope with stress, which is ultimately exacerbated by the addiction.
Effective Treatments Exist: Options for quitting include behavioral therapies, nicotine replacement therapies, medications, and support services like quitlines and mobile apps.
Functional Impairment: Vaping addiction can lead to noticeable functional decline, including declining school performance and increased irritability, especially in adolescents.

Understanding Tobacco Use Disorder and Vaping

With the rise of vaping, the conversation around tobacco use disorder has expanded beyond traditional products. While often marketed as a safer alternative, vaping can lead to a diagnosable substance use disorder.

The Diagnostic Criteria from the DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), categorizes nicotine addiction as "tobacco use disorder," broadening the definition beyond just combustible tobacco. A diagnosis requires exhibiting at least two of 11 criteria within a year. These criteria include using more than intended, persistent desire to cut down, spending significant time obtaining or using, cravings, failing obligations, continued use despite problems, giving up activities, using in hazardous situations, continued use despite knowing the problem, tolerance, and withdrawal.

Vaping and the DSM-5 Criteria

Since most vaping products contain nicotine, dependence on it fits the DSM-5 criteria. Vapers can develop tolerance, withdrawal symptoms, and struggle to quit. High-dose nicotine from vaping can also lead to functional impairment, such as declining school performance in young adults. The ease of using vaping devices can also increase dependency.

Comparison: Vaping vs. Smoking

Some studies suggest e-cigarettes can be as or more addictive than smoking. E-liquids vary in nicotine concentration, and devices allow for more frequent use.


Aspect	Vaping (Nicotine)	Smoking (Cigarettes)
Addictive Agent	Nicotine	Nicotine
Mechanism	Aerosolizing liquid containing nicotine and chemicals	Burning tobacco, releasing nicotine and thousands of chemicals
Speed to Brain	Very rapid, creates a reinforcing "rush"	Very rapid, delivers nicotine within seconds
Health Perception	Often perceived as safer, but still contains harmful chemicals	Recognized for extreme health risks (cancer, heart disease)
Addiction Potential	Studies suggest it can be equally or more addictive due to higher nicotine concentrations and ease of use	Highly addictive due to nicotine content and behavioral reinforcement
Accessibility	Highly accessible, can be used discreetly in more settings	Restricted in many public places, making use less frequent
Long-Term Effects	Risks still being studied, includes potential for lung damage and cardiovascular issues	Well-documented, includes high risk for cancer, heart attack, and stroke

The Vicious Cycle: Vaping and Mental Health

Vaping is increasingly linked to mental health concerns, especially in youth. While some vape to cope with stress, nicotine dependence can worsen anxiety and depression, disrupt sleep, and impair concentration. Early nicotine exposure may also increase susceptibility to mood disorders.

Seeking Treatment for Vaping Addiction

Treatment for vaping addiction focuses on nicotine dependence and includes behavioral therapy, nicotine replacement therapy (NRT), and medications like bupropion and varenicline. Quitlines and support groups also offer confidential help. Consulting a healthcare provider can help create a personalized quit plan.

Quitting vaping is challenging but possible with perseverance and support.

Conclusion

Nicotine addiction from vaping can be classified as a tobacco use disorder under the DSM-5. The diagnosis hinges on nicotine dependence and its negative consequences, not the device. Recognizing this is vital for understanding risks and seeking treatment. With available resources and professional help, individuals can overcome addiction and improve their health.

For more detailed information on substance use disorders, consult the Substance Abuse and Mental Health Services Administration (SAMHSA) at https://www.samhsa.gov/find-help/atod.

Frequently Asked Questions

Yes, a diagnosis of tobacco use disorder is primarily based on the addiction to nicotine, the psychoactive drug found in tobacco. Since most vaping products contain nicotine, the disorder can be diagnosed even if the individual has never used traditional tobacco products.

Yes, some studies suggest that for certain populations, like young adults, vaping can be equally or even more addictive than smoking traditional cigarettes. This is often due to higher nicotine concentrations in e-liquids and the ability to use vaping devices more frequently and discreetly.

Common signs include experiencing cravings, needing to use more nicotine over time to get the same effect (tolerance), experiencing withdrawal symptoms when not vaping (irritability, anxiety), and continuing to vape despite knowing the health risks.

Coverage for vaping cessation varies by plan. However, many insurance companies, including federal employee programs, are expanding their tobacco cessation programs to cover nicotine dependencies from e-cigarettes. It is best to check with your specific provider.

Yes, there are several mobile apps and online resources available. Examples include the quitSTART app and SmokefreeTXT services. These tools can help track your progress, provide tips, and offer support.

Vaping has been linked to poorer mental health outcomes. Nicotine dependence can worsen anxiety and depression symptoms, disrupt sleep, and impair concentration. Many people mistakenly use it to cope with stress, but it can ultimately make mental health issues worse.

Yes, teenagers who vape and become dependent on nicotine can be diagnosed with a tobacco use disorder. Adolescent brains are still developing, making them especially vulnerable to addiction. Nicotine exposure in adolescence can also interfere with brain development.