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Nicotine patches to stop smoking
What are nicotine patches?
Nicotine patches look like oversized sticking plasters and are stuck onto the skin. The patch contains nicotine, which is slowly released into the body through the skin. The nicotine delivered is "clean" - it does not contain the other harmful chemicals released by cigarettes.
How do nicotine patches work?
It is the nicotine in tobacco that makes people addicted to smoking, so when you stop smoking your body craves nicotine. It is this craving that makes you want to start smoking again. This craving is often coupled with nicotine withdrawal symptoms, which include:
- cravings for tobacco
- irritability and outbursts of anger
- loss of concentration
- weight gain
- depression
- headaches
- tiredness
- constipation
- restlessness
- insomnia
- dizziness
- anxiety
Nicotine patches help smokers to overcome any withdrawal effects from stopping smoking by slowly releasing nicotine into the body. However, you will still need to use willpower because nicotine replacement therapy will not completely remove the desire to smoke.
When you use nicotine patches to stop smoking, you start with patches that contain a higher level nicotine in the first few weeks, and then step down to patches containing less nicotine. Patches are available in forms that supply a constant dose of nicotine for 16 or 24 hours but there is no evidence that a 24-hour patch is more effective, or that tapering off patches is more effective than suddenly stopping them.1 Most people use nicotine patches for eight weeks although this varies with the individual and the brand of patch.2
Nicotine from patches is absorbed at a much slower rate into the body than from a cigarette, and there is little evidence that people can become addicted to them.1
When using nicotine patches:
- always apply a patch to a hairless, clean area of skin between the neck and the waist - for example the upper arm, back or shoulder
- try to vary the site each day
- wear each patch all day. Do not remove it to smoke a cigarette!
How successful are nicotine patches?
Using nicotine patches doubles the success rate of people who are motivated to quit, compared with relying on willpower and the advice of a GP.3 Combining nicotine patches with other forms of nicotine replacement therapy may be more effective than using patches alone, and appears to be just as safe. If you smoke more than 10 cigarettes a day using standard strength patches have been found to be more effective than the lower dose patches.4
Are nicotine patches safe?
Nicotine patches are safe for most people who are trying to stop smoking. However, care should be taken if you:
are pregnant or are breastfeeding. Nicotine can affect the blood supply to the developing fetus and so may play a role in slowing the growth of the baby, resulting in a low birth weight. However, the risks of this happening with nicotine replacement therapy are less than the risks of continuing to smoke. Cigarette smoke exposes the fetus to a more intense dose of nicotine and to a number of other harmful chemicals as well.5 Most doctors recommend that pregnant women try other ways of stopping smoking before suggesting nicotine replacement therapy. If nicotine replacement therapy is prescribed, it may be best given on an "as required" basis rather than as continuous therapy with patches.1
have heart disease. Because nicotine can increase the heart rate and blood pressure, people with a history of heart attack or heart problems (such as angina or irregular heartbeats) should take care when using nicotine patches.6 Consult your doctor before using this therapy in such circumstances.
have specific medical problems. People with an overactive thyroid, diabetes, stomach ulcers and severe liver or kidney problems should discuss their condition with their doctor before starting nicotine replacement therapy.2
are under 18 years old. Nicotine replacement therapy is generally not recommended for people under the age of 18, mainly because these products have only been safety tested on adults.
Are there any side-effects?
The main side-effect from using nicotine patches is the possibility of a skin rash developing at the location of the patch. This is sometimes due to the skin reacting to the sticky part of the patch or the nicotine being released. For this reason people with sensitive skin or multiple allergies may find patches unsuitable. Applying the new patch to a different part of the body each day may help, as may simple antihistamine creams.
Other possible side-effects include sleep disturbances or insomnia (removing the patch after 8pm each evening may help here), vivid dreams and nausea.7
What are the benefits of nicotine patches?
- simple to use
- effective
- provide a steady supply of nicotine
- the variable strengths of nicotine patches allow this type of nicotine replacement therapy to be "tailored" to each individual smoker
- discrete - patches can be hidden from sight easily under clothing.
What are the disadvantages of nicotine patches?
- skin irritation and allergic reactions are possible
- there is little benefit in using patches for more than eight weeks8
- it can be tempting to continue to smoke while using patches.
Contacts/further information
Action on Smoking and Health UK (ASH)
Tel:0800 169 0169
Quitline
Tel: 0800 00 22 00
References
- Silagy C, Lancaster T, Stead L et al. Nicotine replacement therapy for smoking cessation. Cochrane review. Cochrane Library Issue 3 2002. Oxford; Update Software.
- National Institute for Clinical Excellence. Technology appraisal guidance No.39 - Guidance on the use of NRT for smoking cesssation.
- Tobacco advisory group of the Royal College of Physicians. Nicotine addiction in Britain. London: Royal College of Physicians, February 2000.
- Report of the Scientific Committee on Tobacco and Health 1998
- National Teratology Information Service 1997. I) Nicotine exposure during pregnancy. ii) Smoking in pregnancy.
- British National Formulary, 2002.
- Monthly Index of Medical Specialties. September 2002.
- Lancaster T et al. Effectiveness of interventions to help people stop smoking. Findings from the Cochrane Library. BMJ 321(5): 355-58.
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