A Guide to Using the Nicotine Patch
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Although an estimated 68 percent of smokers want to quit, according to the Centers for Disease Control and Prevention, the symptoms of nicotine withdrawal, stress, and associated weight gain can all thwart their ability to kick the habit. (Nicotine is a particularly addictive drug that’s an ingredient in cigarettes; withdrawal symptoms include headaches and anxiety.) The good news is that there are many tools at your disposal to help you quit and stay that way — and when you combine them, they may be even more effective.
One of these tools is the nicotine patch, a type of nicotine replacement therapy. A nicotine patch works by releasing a measured dose of nicotine into the skin, helping to wean smokers off their nicotine addiction and lessen the effects of nicotine withdrawal. Here’s what you need to know about trying a nicotine patch for yourself.
Where Can I Find a Nicotine Patch?
Before the U.S. Food and Drug Administration approved the over-the-counter sale of nicotine patches in 1996, they were available only by prescription. Nicotine patches are now available at a wide variety of stores, for about $4 a day or less if you use a generic brand.
Most nicotine patches are made for 24-hour use, says Humberto Choi, MD, a pulmonologist at the Cleveland Clinic in Ohio. But some people may decide to take the patch off before they go to bed, so they wear it only around 16 hours a day.
Leaving the patch on for the full 24 hours can help provide you with a steady dose of nicotine, but you might be more likely to experience a side effect like skin irritation, too. The trade-off is that some people who don’t wear the patch overnight may experience more cigarette cravings in the morning.
The Right Way to Apply a Nicotine Patch
A nicotine patch looks much like an adhesive bandage and comes in a variety of sizes. You’ll put it on in the morning, on a clean, dry, and relatively hairless part of the body between the neck and the waist — for example, on the upper arm or the chest. Do not put the patch on areas of burned, cut, or irritated skin. Change the patch daily. When you apply a new one, be sure to choose a different location to avoid any related skin irritation.
Once you apply a nicotine patch, you’ll wear it continuously throughout the dosage period. Because it takes a few hours for the nicotine in the patch to seep into the bloodstream, you might want to combat any immediate cravings with a piece of nicotine gum or a nicotine lozenge, Dr. Choi says.
While the right nicotine patch dose for you depends on how many cigarettes you smoke daily, the patches are generally used as part of a smoking cessation program that lasts between 8 and 10 weeks, which may follow this pattern:
- Weeks 1–4 You’ll wear a nicotine patch that delivers a strong dose of nicotine — for example, 14 to 21 milligrams (mg) per day.
- Weeks 5–8 You’ll switch to a weaker patch, one that may deliver 7 to 14 mg per day.
- Weeks 9–10 While some people may be ready to stop wearing a nicotine patch after eight weeks, others may want to continue for another week, two weeks, or longer, notes UpToDate. The key is to continue wearing it until you feel stabilized without smoking.
Side Effects of the Nicotine Patch
Most smokers get real relief from the nicotine patch — but they can also experience some side effects. These may include:
- Skin Irritation Some people’s skin may become irritated under the patch. Choosing a new skin site each day usually helps alleviate this problem; if it continues, you can consider switching to another brand of patch. If you develop a rash, redness, or swelling that doesn’t go away in a few days, stop using the patch and tell your doctor.
- Sleep Disturbances Some people using the patch report disruptions to their sleep, such as vivid dreams, insomnia, and other disturbances. If your sleep is still affected after three or four days of using a nicotine patch, try taking the patch off at bedtime. Then, replace it with a new patch in the morning.
- Racing Heartbeat and Dizziness If this occurs, stop using the patch immediately and talk to your doctor about switching to a lower-dose patch. According to a research review, nicotine replacement therapy doesn’t increase a smoker’s risk of having heart problems if they have a history of heart disease. However, if you do have a history of heart disease, be sure to use a nicotine patch under your doctor’s guidance.
- Pain and Nausea This includes headaches, muscle aches, and vomiting.
Choi cautions, though, that some of these symptoms may not be due to nicotine replacement therapy but to nicotine withdrawal itself. So be sure to talk to your doctor about the symptoms you’re experiencing; they can help you pinpoint the cause.
Additional reporting by Maria Masters.
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