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Nicotine Replacement Therapy > Nicotine Patch
Last updated: November 03, 2011
How it works:
- Patches provide a measured dose of nicotine through the skin.
- Each adhesive patch contains a specific amount of nicotine embedded in a pad or gel that steadily travels out of the patch, through the individual's skin, and into their bloodstream.
- The patch may be placed anywhere on a person's torso that is clean, dry, and non-hairy, but most are recommended to be placed on the upper arm.
- Several types and different strengths of patches are available. Typical treatment duration is from 6-14 weeks, with patches normally being worn 24 hours/day.
- Package inserts describe how to use the product as well as special considerations and possible side effects.
What the evidence says:
- Strength of Evidence: A. The Clinical Practice Guideline states that the patch is, “appropriate as a first-line medication for treating tobacco use” with precautions for pregnant women and individuals with cardiovascular disease risks (DHHS, 2008, p. 52).
- Quitting Rates:
- A review of twenty-five studies found that the use of a nicotine patch regimen approximately doubled the possibility of long-term abstinence (as compared to placebo).1
- Nicotine transdermal patches have been shown to increase the success rates of smoking cessation treatments.2
- Coping with Cravings:
- Several clinical trials have found that smokers wearing patches report lower levels of craving to smoke relative to participants in control conditions.3, 4, 5
- Research has indicated that nicotine patches can reduce general levels of cravings in participants abstinent for 90 minutes or 24 hours.6, 7
Possible Side Effects:
- Skin irritation – redness, itching
- Racing heartbeat
- Sleep problems or unusual dreams
- Muscle aches and stiffness
Where to get it:
- Patches can be purchased over-the-counter or obtained using a prescription.
- The Maryland Quitline provides free patches to callers who enroll in free telephone counseling for cessation.
- Some local health departments may provide patches to patients.
- Commercial brands include:
1 Fiore, M. C., Jaen, C. R., Baker, T. B., & al., e. (2008). Treating Tobacco Use and Dependence 2008 Update. Clinical Practice Guideline. In U.S. Department of Health and Human Services (Ed.). Rockville, MD: U.S. Department of Health and Human Services. http://www.ahrq.gov/path/tobacco.htm
2 Fiore, M.C., et al. (1994). The effectiveness of the nicotine patch for smoking cessation: A meta-analysis. Journal of the American Medical Association, 271, 1940-47.
3 Fagerstrom, K.O., et al. (1993). Effectiveness of nicotine patch and nicotine gum as individual versus combined treatments for tobacco withdrawal symptoms. Psychopharmacology, 111, 271-77.
4 Tonnesen, P., et al. (1991). A double-blind trial of a 16-hour transdermal nicotine patch in smoking cessation. New England Journal of Medicine, 325, 311-15.
5 Jorenby, D.E., et al. (1996). Characterization of tobacco withdrawal symptoms: Transdermal nicotine reduces hunger and weight gain. Psychopharmacology, 128, 130-8.
6 Rose, J.E., et al. (1984). Transdermal administration of nicotine. Drug and Alcohol Dependence, 13, 209-13.
7 Leischow, S.J., et al. (1997). Effects of nicotine dose and administration method on withdrawal symptoms and side effects during short-term smoking abstinence. Experimental and Clinical Psychopharmacology, 5, 54-64.