Addiction Nicotine Use How to Quit Smoking Is the Nicotine Patch a Good Way to Stop Smoking? By Terry Martin facebook twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial process Terry Martin Medically reviewed by Medically reviewed by Sanja Jelic, MD on January 21, 2020 Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Review Board Sanja Jelic, MD Updated on January 23, 2020 Print Verywell / Cindy Chung Table of Contents View All Table of Contents Nicotine and Health Risks Is the Patch Effective? Nicotine Patch Dosage Side Effects Smoking With the Patch Due to the health risks of consuming most nicotine-containing products, and the high potential for addiction, many people are searching for ways to decrease their use of these products. Nicotine replacement therapies (NRTs) are a popular choice for decreasing dependence on nicotine, and one of the most popular NRTs is the nicotine patch. The nicotine patch was approved by the FDA in 1991. From 1992 to 1996, the patch was available in the U.S. by prescription only. Since 1996, it has been available over the counter (without a prescription). Other forms of medicinal nicotine products include gum, lozenges, inhalers, and a spray. In recent years, the use of NRTs has decreased in favor of other methods such as tapering with electronic nicotine delivery systems (ENDS). However, the patch is still available and you may want to consider it for smoking cessation. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Nicotine Intake and Health Risks Traditional cigarettes contain 10 to 20 mg of nicotine, and about 1 to 2 mg of that is absorbed by your body when you smoke. Juul, the most popular brand of vape, contains 50 mg of nicotine. Hookah smoking is a global practice for taking in nicotine, and studies show it may actually be more harmful than smoking cigarettes. The hookah smoke is heated by charcoal briquettes. According to a 2016 study, synthetic hookah charcoals contain more heavy metals than most cigarette brands, as well as having higher concentrations of lead. Is the Nicotine Patch Effective? The nicotine patch provides a steady, controlled dose of nicotine throughout the day, thereby reducing the effects of nicotine withdrawal. Patch strength is reduced over time, allowing the user to wean themselves off of nicotine gradually. There are seven first-line medications that consistently have been found to increase long-term abstinence rates: Bupropion (Zybran), varenicline (Chantix), nicotine gum, nicotine inhaler, nicotine lozenge, nicotine nasal spray, and the nicotine patch. All five NRTs have about the same level of efficacy. One major benefit of the nicotine patch, according to a study published in the Archives of Internal Medicine, is that more people use it correctly than they do any other NRT. However, doing this increases the potential for overdose. The combination of counseling and medication is more effective than either alone. Nicotine Patch Dosage Nicotine patches typically come in three different dosage strengths: 21mg, 14mg, and 7mg. These numbers refer to the amount of nicotine in the product. The 21mg patch is usually recommended as a starting point for people who smoke a pack of 20 cigarettes or more daily. From there, following package instructions, the user steps down to lower dose patches until the final step down to no patch. The nicotine patch resembles a square tan or clear bandage. The size depends on the dosage and brand, but generally is between one and two inches square. The nicotine patch should be applied once a day to clean, dry, hairless skin. Manufacturers usually recommend wearing the patch between 16 and 24 hours a day, depending on what you're comfortable with. Possible Side Effects Wearing the nicotine patch to bed at night can disrupt sleep and cause vivid dreams. If this becomes a concern, remove the patch before bed and put a fresh one on the next morning. Some users experience itching, burning or tingling when they first apply the patch. This usually goes away within an hour and is a result of nicotine coming in contact with the skin. Also observed in some people who use the patch: Redness or swelling at the patch site for up to 24 hours Dizziness Headache Upset stomach Vomiting Diarrhea Severe rash or swelling Seizures Abnormal heartbeat or rhythm Difficulty breathing Be sure to consult your doctor before using the nicotine patch and if any of the above symptoms are severe or do not go away. Contraindications Media reports of a possible link between the patch and increased cardiovascular risk have since been shown to be unsubstantiated. Still, be sure to talk to your doctor about the nicotine patch if you have any illnesses or medical conditions, including: Chest pains or a recent heart attack Heart disease Stomach ulcers Thyroid disease Diabetes Skipped or irregular heartbeats Allergies to tapes, bandages or medicines Skin rashes or skin diseases High blood pressure Kidney or liver disease If you take any other medications, be sure to check with your doctor before starting the patch, as it can change the way some medicines work. Smoking While Using the Nicotine Patch Do not smoke when using nicotine patches or any other NRT as you run the risk of overdosing of nicotine. Signs of a nicotine overdose may include: Dizziness Upset stomach Bad headaches Vomiting Cold sweats Drooling Confusion Blurred vision Hearing problems Weakness or fainting If you suspect an overdose, take the patch off and call your doctor immediately. Was this page helpful? Thanks for your feedback! So you're ready to finally quit smoking? Our free guide can help you get on the right track. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Use of FDA-approved pharmacologic treatments for tobacco dependence -- United States, 1984-1998. Updated July 28, 2000. Elsayed Y, Dalibalta S, Abu-Farha N. Chemical analysis and potential health risks of hookah charcoal. Sci Total Environ. 2016;569-570:262-268. doi:10.1016/j.scitotenv.2016.06.108 Tobacco Use and Dependence Guideline Panel. Treating Tobacco Use and Dependence: 2008 Update. US Department of Health and Human Services, updated May 2008. Hajek P, West R, Foulds J, Nilsson F, Burrows S, Meadow A. Randomized comparative trial of nicotine polacrilex, a transdermal patch, nasal spray, and an inhaler. Arch Intern Med. 1999;159(17):2033-8. doi: 10.1001/archinte.159.17.2033. U.S. National Library of Medicine. Nicotine transdermal patch. Updated October 15, 2015. Meine TJ, Patel MR, Washam JB, Pappas PA, Jollis JG. Safety and effectiveness of transdermal nicotine patch in smokers admitted with acute coronary syndromes. Am J Cardiol. 2005;95(8):976-8. doi:10.1016/j.amjcard.2004.12.039 American Academy of Family Physicians. Nicotine patch. Updated March 30, 2020. American Lung Association. What it means to be "nic-sick". Updated October 2, 2019. Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.