Do Nicotine Patches Work? – With Smokefree Clinic

With the right therapy, support, and motivation, a motivated smoker can quit smoking for good.

It’s okay if you’ve tried to quit cold-turkey. While it’s not one of the best ways to quit (most GPs expect motivated smokers to fail their first cold turkey attempt), it’s a step in the right direction.

After your cold-turkey attempt, you’ve most likely read about nicotine replacement therapies (NRT). NRTs contain a small dose of nicotine to cushion the impact of zero nicotine in your body.

Nicotine withdrawals become extremely severe due to nicotine’s absence in the body. The brain, having factored in nicotine in the chemical equilibrium of the body, will keep ‘buzzing’ you to get a hit.

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With NRTs, you can slowly wean yourself off of nicotine until your body does not have any need for it anymore. NRTs are safe to administer and nicotine is relatively harmless to motivated smokers.

It has been proven that NRTs are invaluable in helping motivated smokers abstaining from smoking by making withdrawals much more manageable and tolerable throughout the quitting process.

One form of NRT is a nicotine patch, and you might have asked, “do nicotine patches work?”

Yes they do, and let’s learn more how they do it below.

What is a Nicotine Patch?

Nicotine patches are transdermal patches that administer nicotine through skin absorption. As mentioned, they contain a small nicotine dose designed to wean you off cigarettes.

Many motivated smokers have successfully used patches and other NRT tools to reduce the non-harmful but highly disruptive symptoms of quitting cold turkey. In short, with NRT, they can function as they usually have at work or in any activity without withdrawals buzzing in their brain.

Nicotine withdrawals are the strongest during the first three days of quitting smoking. NRT is designed to cushion the symptoms’ impact. By the first month of quitting smoking, the withdrawal symptoms cease.

Depending on the GP, a motivated smoker can get multiple NRT prescriptions based on their previous nicotine intake.

For instance, due to the slow-acting nature of nicotine patches (they take hours to have nicotine absorbed to the levels you used to smoke), a GP may recommend using gum, nasal spray and lozenges when you’re using patches while experiencing severe withdrawals.

How Do Nicotine Patches Work?

Nicotine patches work by releasing nicotine into the bloodstream via the skin, where the patch is placed.

The patch is applied to the skin much like a bandaid.

To apply your patch, remove the patch from the foil package, peel of the protective strip, and apply the patch to the skin immediately.

Press it into the skin for about 20 seconds to ensure that it sticks properly.

Once the patch is applied, you can shower, bathe, and swim with it on. Be sure to wash your hands with soap and water afterwards to avoid any irritation.

Nicotine Patch Dosage

The right dosage ensures you will only feel the small brunt of withdrawals during your first three days of quitting. Your GP will consider your previous nicotine intake (i.e. the number of cigarettes/packs you used to smoke) in assessing the ideal dosage.

For this reason, you can expect the first dose to be quite high — equal to the daily nicotine intake you used to receive from tobacco.

After a month, your GP will lower your dose every two weeks. So, you can expect your dose to gradually increase every two weeks — the 10th week being significantly lower than your initial nicotine dosage during the first month of stopping smoking.

The aim is to reduce and then ultimately remove your dependence on nicotine. By the third month or 12th week of stopping smoking with NRTs, the GP may have you stop using them entirely.

You’ll still have regular check-ins with your GP to learn how you’re currently managing your withdrawal symptoms during that time.

Depending on your GP, you’ll be using 24-hour or 16-hour patches that have varying strengths, which usually contain 7mg, 14mg, and 21 mg of nicotine.

If you are a heavy smoker (you smoke a pack a day or more), you will likely be advised to use the heaviest strength option. Light smokers (you smoke fewer than 10 cigarettes per day) would use the lighter strength option.

The 16-hour patches are removed before bed and the 24-hour patches are removed and replaced first thing in the morning.

Sidebar: What Is Nicotine Replacement Therapy?

Nicotine Replacement Therapies (NRTs) are products that release nicotine into the body, without releasing the other toxic, harmful chemicals in tobacco.

They are used as a smoking cessation tool.

They are designed to wean you off smoking gradually by reducing the intensity of nicotine withdrawal symptoms, which in turn promotes sustained abstinence from smoking.

NRTs come in various forms, such as gum, lozenges, sublingual tablets, oral inhalers, nasal sprays, and of course, the nicotine patch.

There’s no need to wait to start using an NRT — you can safely begin your NRT treatment as soon as you’ve stubbed out your last cigarette.

Do Nicotine Patches Work?

Yes, nicotine patches have been proven to be effective in helping people abstain from smoking.

While tobacco contains over 7,000 chemicals, nicotine is the chemical in tobacco that makes it addictive. Nicotine causes the brain to release dopamine, which is a feel-good hormone that gives you a ‘rush’.

When you give up smoking, your brain continues to crave that rush, so your body begins to produce uncomfortable withdrawal symptoms — such as cravings, muscle pain, restlessness, stress, coughing, head-cold symptoms, and digestive issues — to push you to reach for another cigarette.

Nicotine patches slowly wean you off nicotine. This allows your body to slowly adjust to functioning without nicotine, reducing the intensity of withdrawal symptoms so that they are more manageable than if you had quit cold turkey.

All forms of NRT can increase chances of quitting by 50 to 60%, though the patch has been shown to be particularly effective.

A 2016 study looked at the effectiveness of three different smoking cessation treatments: nicotine patches, the prescription drug varenicline, and a combined patch and lozenge treatment.

At the six-month mark, 23% of people using the patch had quit, while 24% using varenicline and 27% using the combined treatment had quit.

Interestingly, one-year after quitting, 21% of people using the patch were still abstaining from smoking, compared to 19% on varenicline and 20% using a combine approach.

It has been proven that combining the transdermal patch with another form of NRT can increase the quit rate by 5%. This combined treatment plan is generally considered the best-practice approach for smoking cessation, and presents no additional safety risks.

In 2023, a study suggests that combining fast-acting NRT with patches significantly increase the quit rate of a motivated smoker, which further supports the earlier findings.

Drawbacks of Nicotine Patches

While nicotine patches can help to reduce withdrawal symptoms, it’s important to note that they don’t address the psychological elements of addiction.

This is why it’s essential to seek help from a mental health professional, or regularly discuss how you’re going with your medical practitioner. This is particularly important if you’re struggling with an underlying anxiety or depressive disorder and have been using cigarettes to cope.

Nicotine patches can also cause some unpleasant side effects, including:

• Skin irritation
• Dizziness
• An increased heart rate (this is a sign that your patch dosage is too high)
• Headaches
• Nausea
• Muscle stiffness
• Insomnia

The 24-hour patch can cause sleep disturbances, such as vivid dreams. If this is a problem for you, you can take off your patch before bed and put on a new one first thing in the morning.

If any of these symptoms are occurring for you, be sure to mention them to your GP. They will be able to assess whether your dose is too high or too low, or suggest alternate therapies that you may tolerate better.

Best Place to Put a Nicotine Patch

The best spot for your nicotine patch is on a clean, dry, hairless area of the skin that is unlikely to perspire excessively.

Most people find that the patch works best when placed on an area of the upper body, such as the arm, chest, back, or shoulder.

It’s best to use a different area of the skin each day to prevent irritation from occurring. Avoid putting your patch on oily, scarred, irritated, or damaged skin, as this can stop the patch from sticking properly.

To remove the patch, peel it off carefully and fold it in half so that both of the sticky sides touch, then put it in the bin.

My Nicotine Patch Won’t Stay On — Now What?

If your patch falls off, try applying a new one on a different hairless, clean, dry, non-irritated area of the skin.

Check if the soap you use contains lanolin or moisturisers. These ingredients can interfere with the patch’s adhesiveness, so try using a different soap while using the patch treatment.

Avoid applying any moisturisers, lotions, sunscreens, or skin oils onto the skin before applying the patch. It can be helpful to cleanse the skin with rubbing alcohol, too.

If your patch still doesn’t stick, try putting medical adhesive tape over the patch once it’s applied. Be sure to replace your patch every 16 or 24 hours as instructed on the packet.

Still not sticking? Chat to your doctor about trialling a different brand or product.

Can You Smoke While On Nicotine Patches?

No, you cannot smoke with a nicotine patch on.

Not only can this increase your tolerance and worsen nicotine addiction, but it also puts you at risk of nicotine overdose.

When your body receives too much nicotine, your heart rhythm may be affected and this can be fatal.

Signs of nicotine overdose include:

• Nausea
• Vomiting
• Dizziness
• Diarrhea
• Tremors
• Cold sweats
• Heart palpitations

If you are experiencing any of the above symptoms and are smoking, using a form of NRT, or have smoked while using a form of NRT, call 000.

A Final Word

Nicotine patches have been proven to be effective as a smoking cessation tool.

They are especially effective when combined with another form of NRT, such as nicotine lozenges, gum, or inhalers.

While the road to quitting can be very challenging, you don’t have to do it alone. As well as building up a network of trusted friends and family to support you during this time, it’s important to seek assistance from a medical practitioner.

They will be able to monitor your progress, advise you on NRT dosage adjustments, and suggest additional strategies that may help you along the way.

Link Reference:

• https://jamanetwork.com/journals/jama/fullarticle/2484340
• https://www.racgp.org.au/getattachment/c07241b0-9dc1-41bd-b25b-764389a675c9/Pharmacotherapy-for-smoking-cessation.aspx
• https://link.springer.com/referenceworkentry/10.1007/978-3-030-64477-2_17