Psychopharmacology (2005) 183: 294–299 DOI 10.1007/s00213-005-0192-3 ORIGINAL INVESTIGATION Reuven Dar . Florencia Stronguin . Roni Marouani . Meir Krupsky . Hanan Frenk Craving to smoke in orthodox Jewish smokers who abstain on the Sabbath: a comparison to a baseline and a forced abstinence workday Received: 5 January 2005 / Accepted: 31 August 2005 / Published online: 20 October 2005 # Springer-Verlag 2005 Abstract Rationale: Previous studies suggest that craving for cigarettes is substantially influenced by non-nicotine mechanisms such as habits, cues, and expectations. As or- thodox Jews must refrain from smoking during the Sabbath, examining their craving levels during this habitual absti- nence may be informative in separating smoking depriva- tion from other determinants of craving and withdrawal. Objective: To examine the extent to which the habitual abstinence of Orthodox Jews during the Sabbath is as- sociated with craving to smoke and with other reactions to smoking abstinence. Methods: Twenty orthodox Jewish heavy smokers were assessed three times: on a workday when smoking as usual, on a Sabbath when they never smoke, and on a forced abstinence workday. Craving, irritability, and other commonly reported smoking with- drawal symptoms were assessed retrospectively at several time points during the preceding 24 h. Results: Craving to smoke, and to a lesser extent, irritability, was lower during the Sabbath than during the two other test days. Self- reported difficulty in abstaining was also lower on the Sabbath than on the workday. Craving in the evening preceding the test day was always significantly higher than in the next morning, despite the overnight abstinence before the morning assessment. Conclusions: These results sup- port previous findings in showing that craving to smoke is determined to a large extent by smoking-related habits, cues, and expectations. Keywords Smoking abstinence . Craving . Cues . Expectancy . Habit When habitual smokers attempt to abstain from smoking, they often experience a variety of uncomfortable reactions. These reactions, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association 1994), include dysphoric or de- pressed mood, insomnia, irritability, frustration or anger, anxiety, difficulty concentrating, restlessness, decreased heart rate, and increased appetite or weight gain. While these symptoms are believed to contribute to the mainte- nance of the smoking habit and to the relapse to smoking from abstinence (Willner et al. 1995), they tend to be rel- atively short-lived. In contrast, many smokers who attempt to abstain continue to experience a strong craving to smoke long after other withdrawal symptoms have passed. Indeed, craving to smoke has been described as “potentially the most important feature of cigarette withdrawal” (West and Schnieder 1987) and “the most fundamental and difficult problem for smokers who are trying to quit” (Russel 1988). While craving to smoke typically increases in response to smoking deprivation, it also depends on a variety of other factors, including habits, cues, and expectations. The role of habit in determining craving to smoke and other smoking parameters was demonstrated in a study by Jacober et al. (1994). Smokers were asked to smoke ad lib, abstain, and finally oversmoke in three consecutive after- noons. While abstinence increased craving prior to the first cigarette, it had no effect on craving (or any other smoking parameter) for the rest of the evening. Furthermore, craving peaked at the end of the 4–5 h of forced abstinence period to a level that was much higher than the craving reported in the morning, despite the fact that the latter was assessed R. Dar (*) Department of Psychology, Tel Aviv University, Tel Aviv, 69978, Israel e-mail: ruvidar@freud.tau.ac.il Tel.: +972-3-6408624 Fax: +972-3-6409547 F. Stronguin . R. Marouani . H. Frenk The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel M. Krupsky Pulmonary Institute, Sheba Medical Center Tel Aviv, Israel H. Frenk . M. Krupsky Tel Aviv University, Tel Aviv, Israel