How do I use Nicorette (nicotine) 22 mg patches and cartridges for smoking cessation?

How to Use Nicorette 22 mg Patches and Cartridges

Apply one 22 mg (21 mg) nicotine patch each morning to clean, dry, hairless skin on your upper body or outer arm, and combine it with nicotine cartridges (inhaler) used throughout the day for breakthrough cravings to maximize your chances of successfully quitting smoking. 1, 2, 3

Patch Application Instructions

Daily Application:

• Apply one new patch every 24 hours at the same time each day 4
• Place on dry, clean, hairless skin on the upper body or outer arm 2, 4
• Remove backing and immediately press onto skin, holding for 10 seconds 4
• Rotate application sites daily to prevent skin irritation 2
• Wash hands after applying or removing the patch 4

Wear Duration:

• The 22 mg patch is designed to be worn for 24 hours continuously 1
• If you experience vivid dreams, you may remove the patch at bedtime and apply a new one in the morning 4
• Do not wear more than one patch at a time 4
• Do not leave patch on for more than 24 hours as it loses strength and may irritate your skin 4

Disposal:

• Fold the used patch with sticky ends together and place in the original pouch 4

Cartridge (Inhaler) Use Instructions

How the Inhaler Works:

• The nicotine cartridge fits into a plastic mouthpiece 1
• Draw on it like a cigarette, but the nicotine does not reach the lungs—it stops in the mouth and throat 1
• The inhaler delivers nicotine similarly to nicotine gum 1

Dosing Strategy:

• Use the inhaler throughout the day as needed for breakthrough cravings 1, 2, 3
• This combination approach (patch + inhaler) is recommended as first-line therapy because it nearly doubles your success rate compared to using the patch alone 1, 2, 3

Treatment Duration and Follow-Up

Minimum Treatment Period:

• Continue this combination therapy for at least 12 weeks for your initial quit attempt 1, 2, 3
• If you feel you need to use the patch for a longer period to keep from smoking, talk to your healthcare provider 4
• Treatment may be extended up to 6-12 months to promote continued cessation 1, 3

Follow-Up Schedule:

• Schedule your first follow-up within 2-3 weeks after starting treatment 1, 2
• Have additional check-ins at 12 weeks and at the end of therapy 1, 2

Behavioral Support Component

Essential for Success:

• Use the patch with a behavioral support program such as the one described in the enclosed booklet 4
• Aim for at least 4 counseling sessions during your 12-week treatment period 1, 3
• Combining pharmacotherapy with behavioral counseling significantly increases your quit rates 3, 5

Common Pitfalls and How to Avoid Them

Inadequate Dosing:

• The 22 mg (21 mg) patch is appropriate if you smoke more than 10 cigarettes per day 1, 4
• If you smoke 10 or fewer cigarettes per day, you should start with a lower dose (14 mg patch) 4
• Don't cut the patch in half or into smaller pieces 4

Premature Discontinuation:

• Nicotine withdrawal symptoms typically peak within 1-2 weeks of quitting 1, 3
• Continue therapy even through brief slips—relapse is common and doesn't mean failure 1, 3
• It is important to complete the full treatment course 4

Using Patch Alone:

• The patch prevents withdrawal symptoms from developing but doesn't provide immediate gratification 3
• Adding the inhaler (or other short-acting form) allows you to control breakthrough cravings and nearly doubles your success rate—achieving 36.5% abstinence at 6 months versus 23.4% for patch alone 3, 5

Safety Considerations

Common Side Effects:

• Skin irritation at the patch site is the main side effect 1, 6
• Nausea, mood changes, and sleep disturbances may occur 2, 3
• These effects are generally mild and well-tolerated 1, 6, 7

Cardiovascular Safety:

• NRT is safe even if you have heart disease—blood nicotine levels from NRT remain significantly lower than from smoking cigarettes 1, 2, 3
• If you have heart disease or other specified conditions, talk to your pharmacist or doctor before starting, but know that NRT is safer than continuing to smoke 1

Age Restrictions:

• If you are under 18 years of age, ask a doctor before use 4
• The patch and inhaler are not recommended for people under 18 without medical consultation 1

Key Success Factors

You must be motivated to quit 4

Use one patch daily according to directions 4

Combine with the inhaler for breakthrough cravings throughout the day 1, 2, 3

Complete the full 12-week treatment course 1, 2, 3, 4

Participate in behavioral support or counseling 1, 3, 4, 5