How to Use Nicotine Patches
There are seven medicines approved by the Food and Drug Administration (FDA) to help you quit. They work in different ways. All have been shown to be safe and effective for adults who smoke cigarettes.
These quit-smoking medicines include nicotine replacement medicines (the nicotine patch, lozenge, gum, oral inhaler, and nasal spray) and pill medicines (varenicline and bupropion SR).
Some other strategies, with or without medicines, can help you quit as well.
Nicotine patches come in different shapes and sizes. You put one nicotine patch on your skin in the morning and leave it in place all day. It releases nicotine throughout the day which is absorbed through your skin.
The patch can be used daily by itself to control withdrawal symptoms, or it may be used with nicotine gum or lozenge which are taken as needed for strong cravings.
- For best results, make sure you start on the right dose. The nicotine patch comes in three strengths (7 mg, 14 mg, 21 mg). The right dose for you depends on how much you currently smoke. If you smoke more than 10 cigarettes per day, consider starting on the 21 mg patch. Don’t wear two patches at once unless directed to do so by your healthcare provider. Over time (typically after 8 to 12 weeks), you should lower the dose with the goal of stopping use of the patch completely.
- The nicotine patch is typically worn for 24 hours. The patch can even be worn when showering or bathing. When you wake up, put a fresh patch on clean skin and wear it for a full 24 hours. If you find that you are having vivid dreams or that your sleep is disturbed, you can take the patch off before bed and put a new one on the next morning.
- Put the patch on clean, dry, hair-free skin on the upper body. Usual places to put the patch are the upper chest, upper arm, shoulder, back, or inner arm. Avoid putting the patch on areas of irritated, oily, scarred, or damaged skin. Remove the patch from the foil package, peel off the protective strips, and immediately apply the patch to your skin. Press down to ensure the patch sticks to your skin.
- Wash your hands with soap and water after you apply the patch to wash away any nicotine you may have gotten on your fingers when applying the patch.
- To avoid skin irritation, put the patch on a different area of your upper body each day. Avoid wearing the patch in the same place more than once per week. If the patch loosens or falls off, replace it with a new one.
- When changing your patch, remove the patch carefully and dispose of it by folding it in half with the sticky sides touching. Then apply a new patch to a different part of your upper body.
- Keep out of reach of children and pets. Nicotine patches – even used patches – may have enough nicotine to make children and pets sick. In case of accidental use or ingestion, contact a Poison Control Center right away (1-800-222-1222).
- Quitting smoking may make some people depressed or anxious, whether quitting with medication or not. Get help if you have feelings of depression or anxiety that last for more than two weeks or that get worse.
Learn more about nicotine patches, including side effects and precautions.
- Combine the patch with nicotine gum or lozenge to better manage cravings. You can start using both the patch and gum or lozenge, or you can add gum or lozenge later, if you continue to have withdrawal symptoms. Patches can provide a steady level of nicotine in the body to help lessen withdrawal, while the gum or lozenge can be used to more quickly relieve cravings as they happen.
- If you have a lot of cravings while using the patch, you may not be using a strong enough dose. Consider stepping up to a higher dose. If you are already on the highest dose, talk with your doctor or other healthcare provider for help with dosing. You can also consider adding gum or lozenge, as described above.
- What if I slip up and smoke while using the patch? You do not need to stop using the patch if you slip up and smoke while wearing it. Throw away your cigarettes and get back on track with your quit attempt. Keep using the patch as directed above.
- For best results, use the nicotine patch as part of a program that includes coaching support. Talk with your healthcare provider and connect with your state tobacco quitline (1-800-QUIT-NOW) for help.
- Put it on at the beginning of the day, then forget about it.
- Put it on under clothing, so it is hidden.
- Can be used with other nicotine replacement medicines such as lozenge and gum.
- Provides a steady dose of nicotine all day.
- Can be kept on in the shower.
- Available in several strengths which you can reduce over time to ease you through nicotine withdrawal.
- Side effects are generally minor and can be managed.
- Available without a prescription (over-the-counter)
- You can’t change how much nicotine gets released. If you have withdrawal symptoms you may need to increase your dose or add another medicine.
- May be irritating if you have sensitive skin.
Possible Side Effects (and what you can do about them):
- Skin redness, itching, or burning (rotate the patch to a different site each day).
- Headache (try a lower dose patch).
- Sleep disturbances such as difficulty sleeping and vivid dreams (remove patch at night).
Nicotine Patch Precautions (If any of these apply to you, talk to your doctor or other healthcare provider before starting to use the patch.):
- A heart attack in the last two weeks.
- A serious heart rhythm problem.
- Pain in your heart (angina) that is serious or getting worse.
- Allergy to adhesive tape or other serious skin problems like psoriasis and eczema.
- Could be pregnant or are breastfeeding
- Less than 18 years old.
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