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About half also met criteria for another drug use disorder (in addition to alcohol), and their average Fagerstrom nicotine dependence score was 5.2 (SD = 1.9) on a 0 to 10 scale (The Fagerstrom score is a common method to measure physical dependence on nicotine, and in this sample, average score was on the border between moderate and high dependence)

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These alkaloids act as central nervous system stimulants and produce psychoactive effects such as a transient sense of well-being, relaxation, heightened alertness, increased performance, and decreased fatigue

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