Craving was not included in the DSM-IV withdrawal symptoms because of evidence that it sometimes does not increase in response to a discontinuation of tobacco use [84]. This may reflect the fact that the rise-time of craving after smoking discontinuation is often so rapid that fine temporal resolution is needed to detect it [65, 85]. However, most research shows that craving reports typically escalate in response to tobacco abstinence and are significantly associated with other elements of that syndrome [78, 86–89]. In addition, as noted earlier, craving is the withdrawal symptom that is most highly predictive of cessation success [14, 19, 59, 75, 77]. Thus, DSM-5 should assess craving that occurs as part of the withdrawal syndrome (Criterion 2), and more generally as well (Criterion 1).
