A padrão of nicotine uso that has caused damage to a person’s physical or mental health. The padrão of nicotine uso is evident over a period of at least 12 months if substance uso is episodic or at least one month if uso is continuous (i.e., daily or almost daily). Harm to health of the individual occurs due to one or more of the following: (1) direct or secondary toxic effects on body organs and systems; or (2) a nocivo route of administration.