Nicotine patches

Patches (transdermal nicotine systems)give a measured dose of nicotine through the skin. You are weaned off nicotine by switching to lower-dose patches over a course of weeks. Patches can be bought with or without a prescription. Many types and different strengths are available. Package inserts describe how to use the product, and list special considerations and possible side effects.

The 16-hour patch works well if you are a light-to-average smoker. It is less likely to cause side effects like skin irritation, racing heartbeat, sleep problems, and headache. But it does not deliver nicotine during the night, so it may not be right for those with early morning withdrawal symptoms.

The 24-hour patch provides a steady dose of nicotine, avoiding peaks and valleys. It helps with early morning withdrawal. But there may be more side effects like disrupted sleep patterns and skin irritation.

Depending on body size, most smokers should start using a full-strength patch (15-22 mg of nicotine) daily for 4 weeks, and then use a weaker patch (5-14 mg of nicotine) for another 4 weeks. The patch should be put on in the morning on a clean, dry area of the skin without much hair. It should be placed below the neck and above the waist -- for example, on the upper arm or chest. The FDA recommends using the patch for a total of 3 to 5 months.

Side effects are related to:

* The dose of nicotine
* The brand of patch
* Skin characteristics (such as the person's tendency to have a skin reaction to the patch)
* How long the patch is used
* How it is applied

Some possible side effects of the nicotine patch include:

* Skin irritation -- redness and itching
* Dizziness
* Racing heartbeat
* Sleep problems or unusual dreams
* Headache
* Nausea
* Vomiting
* Muscle aches and stiffness

What to do about side effects:

* Do not smoke while you are using a patch.
* Try a different brand of patch if your skin becomes irritated.
* Reduce the amount of nicotine by using a lower-dose patch.
* Sleep problems may be short-term and go away in 3 or 4 days. If not, and you're using a 24-hour patch, try switching to a 16-hour patch.
* Stop using the patch and try a different form of NRT.