Certified in Public Health (CPH) Practice Exam

What factor primarily drives cigarette smoking once it has begun?

1. The social environment

2. The addictive power of nicotine

3. The influence of advertising

4. The availability of cigarettes

The correct answer is: The addictive power of nicotine

The primary factor that drives cigarette smoking once it has begun is the addictive power of nicotine. Nicotine is a psychoactive substance found in tobacco that creates dependency in users. When individuals smoke, nicotine quickly reaches the brain, stimulating the release of neurotransmitters like dopamine, which can create feelings of pleasure and reward. This reinforcement can lead users to continue smoking even when they may want to quit, as the body develops a tolerance and experiences withdrawal symptoms when nicotine levels drop. While the social environment, influences of advertising, and accessibility of cigarettes can all play significant roles in initiating and maintaining smoking behavior, it is the physiological dependence on nicotine that is most critical in perpetuating the habit once an individual has started smoking. The cravings and withdrawal associated with reduced nicotine intake solidify the smoking behavior, making it a deeply entrenched addiction that can be difficult to overcome without intervention. Thus, nicotine's addictive properties are central to understanding the persistence of cigarette smoking.