Irritability in Medicine / Internal Medicine — 28yo Man | Psychiatry | SMLE Q#1468
SMLE Question #1468
Medicine / Internal Medicine
Psychiatry
Last updated: February 2026
A 28-year-old man requests help to quit smoking. He has smoked 1 pack of cigarettes daily for 10 years. He has made multiple quit attempts but relapses within days with irritability, restlessness, and strong cravings. He reports continued smoking despite wanting to stop. Which of the following is the most direct pharmacologic effect of nicotine that best explains his difficulty stopping smoking?
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