- F17
- Substance Use Disorders
Mental and Behavioural Disorders Due to Tobacco Use (F17)
DSM-5-TR: Tobacco Use Disorder
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF10-F19
- Subcodes4 subcodes
- Australian PrevalenceDaily smoking rate is approximately 10.7% (AIHW 2022-23), down from over 30% in the 1980s. Highest rates in Aboriginal and Torres Strait Islander communities (~40%). Smoking remains the leading preventable cause of death in Australia.
- Global PrevalenceApproximately 1.3 billion people use tobacco worldwide. Tobacco causes approximately 8 million deaths annually, making it the leading preventable cause of death globally.
- Duration RequirementDependence syndrome (F17.2): three or more features present simultaneously for at least one month, or repeatedly within a 12-month period
Overview
Covers disorders arising from tobacco and nicotine use, primarily dependence and withdrawal. Tobacco use disorder is the most prevalent substance use disorder globally, though it is often under-recognised in mental health settings.
Diagnostic Criteria (ICD-10)
Core Features
- Strong desire or compulsion to use tobacco or nicotine products
- Difficulty controlling tobacco use in terms of onset, termination, or amount
- Physiological withdrawal state when use is reduced or stopped
- Evidence of tolerance — more tobacco required for the same effect
- Progressive narrowing of the repertoire of tobacco use patterns
- Persistent use despite clear evidence of harmful consequences
Duration Dependence syndrome (F17.2): three or more features present simultaneously for at least one month, or repeatedly within a 12-month period
Exclusion Criteria
- Occasional social smoking without features of dependence or harm
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F17.0 | Acute intoxication | Transient condition following tobacco/nicotine use, characterised by nausea, dizziness, and autonomic effects (rarely coded clinically). |
| F17.1 | Harmful use | Pattern of tobacco use causing damage to physical health (respiratory, cardiovascular, oncological). |
| F17.2 | Dependence syndrome | A cluster of physiological and behavioural phenomena with strong desire to smoke, difficulty controlling use, tolerance, and withdrawal on cessation. |
| F17.3 | Withdrawal state | Symptoms occurring on tobacco cessation, including irritability, anxiety, difficulty concentrating, increased appetite, and strong craving. |
Classification Boundaries
Includes
- Nicotine dependence
- Tobacco dependence
- Cigarette smoking dependence
- Tobacco withdrawal
Australian Clinical Context
Australia is a global leader in tobacco control, with plain packaging (introduced 2012), one of the world's highest tobacco tax rates, and the Quitline service (13 QUIT). The daily smoking rate has fallen from over 30% in the 1980s to approximately 10.7% in 2022. PBS-subsidised cessation aids include nicotine replacement therapy (NRT), varenicline (Champix), and bupropion.
Medicare (MBS) Pathways
Specialist Referral Pathway
Conditions in this category do not have a structured allied health Medicare pathway. Treatment is typically managed through specialist psychiatrist or physician consultations, with additional support through state/territory services or NDIS.
No structured session limit — standard specialist consultation items apply
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
| Geriatrician / Physician | Standard specialist consultation items | Specialist medical consultation |
GP referral items: Standard GP referral to specialist
Eligibility: Referral to specialist required. No structured allied health pathway under Medicare for these conditions.
Tobacco use disorder is explicitly excluded from Better Access. Smoking cessation programs are funded separately through PBS and Quitline services.
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
Tobacco use disorder is highly prevalent among people with mental illness (rates 2–3 times the general population). The Fagerström Test for Nicotine Dependence (FTND) assesses dependence severity. Brief intervention ("5 As") is recommended in primary care and mental health settings. Varenicline has superior efficacy over NRT for cessation.
Frequently Asked Questions
Should tobacco use disorder be coded in mental health settings?
Yes. Tobacco use disorder is highly comorbid with mental illness and should be actively identified and coded. People with serious mental illness have smoking rates 2–3 times higher than the general population and die 10–20 years earlier, largely from smoking-related illness. Addressing tobacco use is an important part of holistic mental health care.
References
- World Health Organization. ICD-10-AM.
- American Psychiatric Association. DSM-5-TR. 2022.
- AIHW. National Drug Strategy Household Survey.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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