How do I use nicotine replacement patches to quit smoking?

How to Use Nicotine Replacement Patches

For smokers who want to quit, nicotine replacement patches should be applied once daily to clean, dry, hairless skin, starting with the highest strength patch (21mg for those who smoke more than 10 cigarettes per day) and gradually stepping down to lower doses over 8 weeks. 1

Patch Selection and Dosing

• For smokers of more than 10 cigarettes per day, follow this schedule 1:

  • Weeks 1-4: Step 1 (21mg patch/day)
  • Weeks 5-6: Step 2 (14mg patch/day)
  • Weeks 7-8: Step 3 (7mg patch/day)

• For lighter smokers (10 or fewer cigarettes per day), start with Step 2 (14mg) for 6 weeks, then Step 3 (7mg) for 2 weeks 1

• Standard strength patches (21mg) are more effective than lower dose patches for medium to heavy smokers 2

Proper Application Technique

• Apply one new patch every 24 hours to clean, dry, hairless skin 1
• Remove backing and immediately press onto skin, holding for 10 seconds 1
• Wash hands after applying or removing the patch 1
• Apply the new patch at the same time each day to a different skin site 1
• Do not cut patches into smaller pieces 1
• Do not wear more than one patch at a time unless specifically directed by a healthcare provider 1

Duration of Treatment

• Complete the full 8-week treatment course for best results 1
• If you feel you need to use the patch for longer to avoid returning to smoking, consult your healthcare provider 1
• Evidence suggests that longer treatment with nicotine patches (>14 weeks) may be more effective than standard duration 2, 3

Managing Side Effects

• If you experience vivid dreams, you may remove the patch at bedtime and apply a new one in the morning 1
• Skin irritation is the most common side effect but rarely causes people to discontinue use 4
• Do not leave patches on for more than 24 hours as this may irritate your skin and the patch loses effectiveness after this time 1

Enhancing Success

• Use patches in combination with behavioral support programs for best results 1
• Combination NRT (using patches plus a fast-acting form like gum or lozenge) increases success rates by 25% compared to single form NRT 2, 3
• The 24-hour patch (21mg) provides better control of cravings, especially morning cravings, compared to 16-hour patches 5
• Follow the instructions in the package and seek advice from a pharmacist if more information is needed 2

Special Considerations

• NRT appears to be safe for smokers with cardiovascular disease, though package inserts may advise consulting a healthcare provider first 2
• Pregnant smokers should consult with their healthcare provider before using NRT, though it is generally considered safer than continued smoking 2
• The choice between different NRT products (patch, gum, inhaler, etc.) is largely a personal preference, as they have similar success rates 2

Common Pitfalls to Avoid

• Don't stop using patches too early - complete the full treatment course 1
• Don't smoke while using the patch as this can lead to nicotine overdose 1
• Don't use lower doses than recommended for your smoking level 2
• Don't be discouraged by mild side effects, which typically resolve within a week 2
• Don't forget that the patch only addresses the physical addiction; behavioral support increases your chances of success 1, 6