Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Nicotine Patch

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
  • Dizziness
  • Racing heartbeat
  • Sleep problems or unusual dreams
  • Headache
  • Nausea
  • Vomiting
  • 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:
    • Habitrol: Round patches come in three strengths: 21, 14, or 7 mg of nicotine per patch; worn 24 hours per day.

    • Nicoderm CQ: Rectangular patches come in three strengths: 21, 14, or 7 mg of nicotine per patch; worn 24 hours per day.

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.

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.