Tobacco Use Disorder

Geraldin Noverina (18/423145/PS/07526)

Javier Sebastian (18/423146/PS/07527)
Kautsar M Wiroto (18/423147/PS/07528)
Nabila Hilina (18/423158/PS/07529)
Sabrina Andjani Denny K. (18/423151/PS/07532)
Information about the subject

- Male
- 18 Years old
- Indonesian
- Undergraduate Student
- Healthy (no past disability nor serious
genetic diseases)
When & How in Conducting The Interview

15:45 Monday, 16th November 2020

● Structured Interview
○ An interview which relies on questions that are standardized and premeditated
● Face-2-face
○ Interviewer and interviewee met in a scheduled place and time
● Recorded
○ Interviewee agreed to be recorded before the interview began
Interview Questions
➔ From what age did you start smoking?
➔ Currently, how many cigarettes do you smoke
in a day? (10)
◆ When you started smoking, how many
cigarettes did you smoke in a day?
➔ Have your close friends/family ever
commented on your use of cigarettes? (6)
◆ Are there ever any arguments about it?
➔ How often do you crave smoking? (4)
Interview Questions
➔ Have you ever made an effort to reduce or
quit smoking? (2)
◆ If yes, what was it like? Did you
experience any negative symptoms e.g.
irritability, anxiety etc? (11a, tobacco
withdrawal Criterion B)
◆ Did you go back to smoking in order
to relieve the symptoms? (11b)
➔ Have you ever experienced physical
symptoms because of smoking? (9)
Information from the Interview
Duration of smoking
- Three years of smoking.; he started in the first year of high school

Amount of smoking
- These days he smokes around 5 cigarettes a day
- In the past, he used to smoke up to two packs a day (in 12th grade)

Reasons for smoking

- To relieve stress from school work and committee activities
- These days, he says that he can stop smoking at any time, but he keeps smoking just
because he likes it/wants to do it.
Information from the Interview
Efforts made to reduce or quit smoking
- He says that he has made the effort to stop several times, but that he usually starts smoking
again if he faces pressures from school or committee activities
- One time, he managed to stop smoking for two months
- During quarantine, he managed to stop smoking for 5 months before starting again due to
school stress (Japanese class)

Cravings
- In the past, he craves smoking every day & he craves it more when he sees his friends
smoking
- These days, he craves smoking whenever he has a chance to smoke e.g. when no one else
is awake, he will go outside to smoke in order to avoid suspicion
Information from the Interview
Physical and emotional effects of smoking
- During the peak of his smoking habit (12th grade/2 packs a day), he experienced shortness
of breath and getting tired faster during PE class
- During periods where he stops smoking (e.g. 5 months), he feels cravings for only 1-2
days. After around a week, he feels quite relaxed; he doesn’t experience symptoms like
anxiety, restlessness, or irritability.

Who knows about his smoking habit?

- He only hides his ‘cigarette addiction’ from his parents only, but not his friends and other
relatives
- His other relatives do not comment on his smoking habit; while some of his friends
suggest that he should only smoke a little bit
Analysis (DSM-V)
A.1 The client has smoked in large amounts and over a long period, with some breaks.

A.2 The client has successfully quit for months multiple times but always relapses.

A.3 Obtaining cigarettes, especially in Indonesia, is not at all time consuming.

A.4 The client seems to have a constant desire of smoking.

A.5 The client often start smoking to help himself fulfill role obligations, the opposite of
causing interference.

A.6 The client hides his smoking habits from his parents but some of his friends
discourage him from smoking, though arguments were not indicated.
Analysis (DSM-V)
A.7 The client smokes as a way to relieve the stress from school and committee activities,
to avoid giving them up entirely.

A.8 The client indicated that he hides his smoking habits by smoking outside.

A.9 The client continues tobacco use despite symptoms like shortness of breath and
getting tired faster during physically rigorous activities.

A.10 The client used to show tolerance symptoms, but has reduced their consumption.

A.11 The client has indicated the presence of withdrawal symptoms but only for the first
few days.
Diagnostic Conclusion
Based on the information derived from the interview, it can be concluded that the client
tends to develop Tobacco Use Disorder. The client experiences 11 symptoms from the
diagnostic criteria of the disorder in DSM-V. The severity of the disorder is categorized as
Severe since the client presence of more than 6 symptoms.
Treatment Plan - Mindfulness
- Aims to increase awareness of and detachment from sensations, thoughts, and cravings that may
lead to relapse
- Subject learn coping techniques that help them deal with negative emotions (stress, and
cravings) without returning to tobacco use or other unhealthy behaviors.
- Provides information about cognitive-behavioral skills such as :
- Effective coping skills
- Self-efficacy
- Recognizing antecedents of relapse

Witkiewitz et al., 2014)

References
Witkiewitz, K., Bowen, S., Harrop, E. N., Douglas, H., Enkema, M., & Sedgwick, C. (2014). Mindfulness-Based Treatment to
Prevent Addictive Behavior Relapse: Theoretical Models and Hypothesized Mechanisms of Change. Substance Use & Misuse,
49(5), 513–524.doi:10.3109/10826084.2014.891845