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Clinical documentation should reflect the DSM-5 criteria used to establish dependence typically two or more of the eleven diagnostic criteria within a 12-month period to support medical necessity, particularly when tobacco cessation counseling services are being billed alongside this diagnosis

Nicotine constricts veins, causing decreased blood flow, carbon monoxide reduces the amount of oxygen red blood cells carry to the skin, and hydrogen cyanide inhibits the enzymes need to transport oxygen and increases the metabolic profile of your body

Sossi V, Holden JE, de la Fuente-Fernandez R, Ruth TJ, Stoessl AJ

In 2015, $8.9billion was spent on advertising and promotion of cigarettes and smokeless tobacco combined