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Nicotine Replacement Therapy (NRT)

The Nicotine Patch

What Is It?
The patch is a self adhesive, nicotine containing membrane that looks like an oversized band-aid. Unlike the nicotine in smoke, which passes almost instantaneously to the brain via the lungs, nicotine in the patch can take up to three or four hours to reach peak levels in your blood, and is continuously released while the patch is on. Nicotine can still be absorbed from the skin for up to two hours after the patch is removed. This slow delivery allows for a more consistent level of nicotine in the blood, which helps diminish cravings. Using the patch approximately doubles the likelihood of successfully quitting smoking, compared to taking no quit medications.

How do I use the nicotine patch?
Apply the patch to a clean, hairless place on your skin. Most people favor the upper arms or the shoulders; there is, however, no reason to avoid using other locations such as your legs, thighs or even your forehead!

Make sure you read and follow the directions enclosed with the medication, as well as any given to you by your doctor. Don't apply the patch to the same location repeatedly; find several locations and rotate among them. This should decrease any problems with skin irritation you might experience.

What is the dose?

  • If you smoke more than 10 cigarettes per day, use according to the following 10 week schedule:
    • STEP 1 - use one 21 mg patch/day (weeks 1-6)
    • STEP 2 - use one 14 mg patch/day (weeks 7-8)
    • STEP 3 - use one 7 mg patch/day (weeks 9-10)
  • If you smoke 10 cigarettes or less per day, do not use STEP 1 (21mg). Start with STEP 2 (14mg) for 6 weeks, then STEP 3 (7mg) for 2 weeks and then stop.
  • Highly addicted smokers may opt to use the patch for 24 hours to avoid morning cravings.
  • A patch is usually worn for 16 hrs or 24 hrs.
  • The patch is first applied upon awakening on the quit day.
  • A new patch is applied daily.

To help you determine if the patch is right for you, consider using the QuitNet Medication Wizard.

More medically specific information ...

Content author: Alan S. Peters, CTTS-M
Reviewed by: Ann Wendling, MD, MPH, April 2013

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