Nicotine Patch

See FDA package insert for more complete information

The nicotine patch is available over the counter and in prescription form. Find out if your insurance will reimburse you for the prescription patch. Doses and how long they are worn vary in the different brands and your doctor may help select the right one for you. Generic patches are also available, often at lower costs. The recommended duration of usage is 8 weeks, which is as effective as longer treatment.

How Well Does It Work?

Studies have shown that the nicotine patch nearly doubled long-term abstinence rates when compared to a placebo (Fiore et al., 2008).



  • Cardiovascular disease: Nicotine replacement therapies (NRTs), such as nicotine gum, have not been proven to increase the risk of having a heart attack, but should be used with caution in people who have had a heart attack within 2 weeks. The gum also might not be right for you if you have a history of coronary heart disease, serious arrhythmias, or vasospastic diseases.

  • Pregnant or nursing women: If you are pregnant or nursing, you should consult your doctor. Pregnant women are encouraged to quit without medication. It is most important that you quit smoking. The nicotine inhaler has not been shown to be effective in treating tobacco dependence in pregnant smokers and it has not been evaluated in breastfeeding patients. The risks of such drugs to unborn children are not fully known. Seeking intensive counseling support in your quit attempt is a good idea.

  • The patch might not be right for you if you have hyperthyroidism or insulin-dependent diabetes.

  • The patch might not be right for you if you have active peptic ulcers.

  • The patch might not be right for you if you have malignant hypertension.

Who Shouldn't Take This Medication?

  • Pregnant women: Because nicotine can damage or impair the fetal brain, if you are pregnant you should not use the patch. Talk to your doctor about other nicotine replacement therapies.

Side Effects

  • A local skin reaction may occur but is usually mild

  • Insomnia

  • Nausea, vomiting, headache, dizziness, cold sweat, pallor, and weakness are all symptoms of an overdose.

How Do I Take This Medication?

  • A patch should be applied immediately upon waking up on your quit date.

  • At the start of each day, place a new patch onto a relatively hair-free area on the skin, anywhere between your neck and waist.

  • Patches are to be applied once a day. The 24-hour patch can be removed at night if sleep disturbance is a problem. Alternatively, you could use the 16-hour patch.

  • After the initial treatment period of 4 to 6 weeks, decrease dose by 7 mg every 2 weeks.

(Fiore et al., 2000; PDR, 2001; Slotkin, 1998)

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