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To diagnose, at least two of the symptoms in the DSM-5 diagnostic criteria must occur within a 12-month period, including persistent nicotine cravings, difficulty quitting despite unsuccessful efforts, using tobacco in situations where it is physically hazardous, neglecting responsibilities due to tobacco use, and experiencing nicotine withdrawal symptoms

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Daily use of cannabis before the onset of the syndrome was nearly universal, with over 40% of respondents reporting they used marijuana more than 5 times a day