A complete guide to the nicotine patches

Sep 25, 2018
Medically reviewed by Dr. Maroof Ahmed, MD on 
Oct 27, 2019

The nicotine patch was developed in the 1980s after a small team of health care researchers in California discovered that nicotine could be absorbed through the skin, and that the effects of this could help to reduce cigarette cravings in smokers. In the absence of volunteers on whom to test these effects, the scientists reportedly experimented on themselves, by rubbing tobacco leaves onto their skin and measuring their bodies’ physiological reactions! They filed for US patent of the transdermal nicotine patch in 1988, and today it remains one of the most popular quit smoking aids available on the market.

Nicotine Replacement Therapy Explained

Nicotine replacement therapy (NRT) is a class of healthcare products that release low and controlled quantities of nicotine, without the other harmful substances found in tobacco such as tar and carbon monoxide. These harmful substances can increase the likelihood of conditions such as cancer and heart disease (heart attacks, high blood pressure and irregular heartbeats).

They’re used as stop smoking aids, as they can help to reduce the nicotine withdrawal symptoms that many people experience when they give up cigarette smoking. They can also limit weight gain after quitting smoking by reducing energy intake.

When people quit ‘cold turkey’ — without the use of any medication and without expert support — these withdrawal effects can be so difficult to overcome that many succumb to relapse. That’s why the cold turkey method is no longer recommended by health professionals, and instead, the use of NRTs is encouraged for those who feel that they would benefit from them, as part of a planned smoking cessation programme.

Nicotine replacement therapy is not intended as a long-term solution to a nicotine addiction, but rather it’s designed to help with the transition between cigarette smoking and being entirely nicotine-free.

In fact, a recent review of the current scientific evidence and clinical trials found that the use of NRTs can increase a person’s chance of successfully quitting smoking by a massive 50-60% — so you definitely shouldn’t overlook these products if you’re considering a quit attempt!

NRTs come in various forms (nicotine patches, nicotine gum, nicotine lozenges, habitrol and more), and it’s key to read all the important information so that you can find the one that works best for you. Here, we focus on nicotine patches, and cover everything you need to know about these products as you begin your smoke-free journey.

What are nicotine patches?

A nicotine patch is a form of nicotine replacement therapy (NRT), designed to help people quit smoking. It’s a transdermal patch, meaning it delivers a specific amount of nicotine through the skin and into the bloodstream, once applied.

Although all NRTs deliver nicotine to the brain at a slower rate than cigarettes, the release of nicotine from patches is the slowest of all NRT products. Rather than providing a ‘quick hit’ of nicotine in the way that some other products do, nicotine patches are designed to provide the body with a steady supply of nicotine throughout the day and in most cases, throughout the night too.

Nicotine patches are designed to provide the body with a steady supply of nicotine throughout the day.

Who should use them?

If you’re considering a quit smoking attempt, using NRTs could make things a whole lot easier. Though they only tackle the physical aspect of your smoking habit (you’ll still need to address the behavioural side of things), using NRTs can significantly reduce nicotine withdrawal symptoms and cigarette cravings, making it less likely that you’ll give in to temptation.

There is no evidence to say that one form of NRT is more effective than the other, however, so the product, or combination of products that you choose is entirely down to you.

Nicotine patches may be beneficial for those who prefer to tackle withdrawal symptoms in a more discreet way, since the patches (which are now available to match different skin tones) can be applied to an area that’s hidden beneath your clothes, and can be left in place for the entire day. Some people also find that nicotine patches are less hassle, since you simply have to apply them in the morning and don’t have to worry about carrying anything around with you, or remembering to actively use the product throughout the day, as would be the case with nicotine gums, lozenges or nasal sprays.

You can also be confident that your body is receiving a steady supply of nicotine, and this may help with the psychological aspect of your cravings, as well as the physical. Lastly, not everyone like the taste of oral NRTs, so if that’s the case, a nicotine patch could be a better alternative.


Though a great deal safer than cigarettes, NRTs still contain nicotine, so are not entirely risk-free. However, most experts agree that they are a far better alternative to smoking, and that the benefits therefore outweigh the risks. Nevertheless, certain individuals should take extra caution before using these products, in order to minimise any adverse effects.

If you’re pregnant or breastfeeding, you should visit your GP before continuing use of these products. That’s not to say that you won’t be able to use them, but it’s best to seek expert advice first, to ensure your baby isn’t put at risk.

Similarly, if you have a long-term health condition, it’s worth informing your GP of your plans to quit smoking in order to minimise any drug interactions or worsening of symptoms. Your GP will then be able to offer you personalised advice with regards to quit smoking aids.

Due to the application of nicotine patches, those with skin conditions such as eczema may find that these products exacerbate symptoms. Equally, those who are allergic to adhesive tape should steer away from nicotine patches and instead choose another form of NRT.

How to use nicotine patches

Step 1: Choosing the strength

Nicotine patches come in three strengths, and are labelled according to how much nicotine they supply over a 24-hour period:

  • 7mg/24 hour (low strength)
  • 14mg/24 hour (medium strength)
  • 21mg/24 hour (high strength)

The strength that’s right for you will depend on the amount of cigarettes you would usually smoke. If you’re a heavy smoker, or usually smoke more than 10 cigarettes each day, you should start with a high strength nicotine patch, whereas the medium strength will usually be sufficient for a lighter smoker.

Regardless of the strength you start with, it’s important to remember that nicotine patches — like other forms of NRT — are not intended as a long-term solution to your smoking habit, and therefore use of these products should be reduced over time. Generally, patches are recommended for 8-10 weeks, though towards the end of the usage period you should switch to a lower dose in order to gradually wean yourself off nicotine.

The product you purchase will come with a set of directions, however if you are confused or wish to clarify the strength that you should be using or the correct timescale of use, you can visit your local GP or stop smoking service, or alternatively speak to a pharmacist.

Step 2: Applying the patch

A nicotine patch effectively looks like a large plaster, or bandage. The outer part of the patch contains an adhesive, so it’s this part that sticks to your skin and holds the patch in place. The inner part of the patch contains the nicotine, and is pressed close to the skin in order to enable the effective release and delivery of nicotine.

You should apply the patch to an area of skin that has a minimal amount of hair, such as your upper arm, hip or upper chest. The area of skin you choose should also be clean and dry before application. After removing the protective seal, apply the patch straight away, avoiding touching the adhesive as much as possible. Once stuck to your skin, press down firmly on the patch for around 10 seconds to ensure it is flat and secure, before washing your hands once you’re finished. If the patch becomes loose or falls off, simply replace it with another.

When it’s time to change the patch, peel it away from your skin, fold it in half and dispose of it immediately. You should apply the new patch to a different area of skin, though a skin site can be reused after a period of one week.

Step 3: Use in conjunction with behavioural therapy.

Nicotine patches only address the physical side of addiction. A behavioural therapy app, like Quit Genius, works in conjunction with the patches to deal with the psychological part of addiction!

Side effects

As with any medication, some people experience side effects while using nicotine patches. Possible side effects include:

  • Itching or skin irritation (skin redness)
  • Headaches
  • Increased heart rate and blood pressure
  • Dizziness
  • Nausea
  • Vivid dreams (rare)

These symptoms are usually mild, serious reactions are exceedingly rare. If they appear to be worsening after your start date, or if they’re impacting your ability to use the products as intended, seek advice and health information from a health care professional such as your GP or pharmacist.

If you experience any signs of an allergy, such as a rash, swelling, hives or difficulty breathing, discontinue use of the patch immediately and seek medical attention as soon as possible.

Where to buy

In most countries, nicotine patches are available over the counter, meaning you don’t need a prescription to purchase them.

You can buy them from your local pharmacy or drugstore, as well as many supermarkets and online retailers.

Take home message

If you’ve made the decision to tackle your smoking habit, now is a great time to consider how nicotine replacement therapy can help you on your way. Nicotine patches, in particular, offer a discreet and hassle-free way of combating cigarette cravings, by providing your body with a steady dose of nicotine throughout the day.

However, the type of quit smoking aid you choose is dependent on your preferences, and it’s important to choose a product that you feel comfortable using. Take your time and do your research, but try to decide on a method prior to your quit date, so that you can have everything in order and be completely prepared as you set out to enjoy the benefits of a healthier, happier, smoke-free life!

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