To examine the alignment of criteria for tobacco use disorder with those for other substance use disorders, an item response theory analysis of the seven dependence criteria, three abuse criteria, and craving was performed in a large adult sample of smokers (45). The 11 criteria formed a unidimensional latent trait intermixed across the severity spectrum, significantly increasing information over a model using DSM-IV nicotine dependence criteria only. Differential item functioning was found for craving and hazardous use, but differential total score functioning was not found. The proposed tobacco use disorder criteria (individually and as a set) were strongly associated with a panel of validators, including smoking quantity and smoking shortly after awakening (181). The tobacco use disorder criteria were more discriminating than the DSM-IV nicotine dependence criteria (181) and produced a higher prevalence than DSM-IV criteria, addressing a DSM-IV concern (163). An item response theory secondary analysis of 10 of the 11 criteria from adolescent and young adult substance abuse patients (71) also revealed unidimensionality and a higher prevalence of DSM-5 tobacco use disorder than DSM-IV nicotine dependence (71).
