Do nicotine patches work?
Yes, they raise your odds of quitting. Any nicotine replacement lifts them by 50 to 60%. But a patch on its own is the weaker way to use one. One small extra helps more.
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Do nicotine patches work?
Yes. A review of 133 trials found any nicotine replacement therapy (NRT) made quitting 50 to 60% more likely. Patches gave the same chance of quitting as gum, lozenges or sprays.
That’s 50 to 60% more than people who tried without it. It doesn’t mean half of people quit.
A patch gives a slow, steady dose through your skin all day. It can’t step in fast when a sudden craving hits.
That extra is a fast-acting product, like gum, a lozenge or a mouth spray. Think of the patch as the heating in your home, and the gum as a jumper you grab when a draught hits. You want both on a cold day.
| What people used | Compared with | What trials found |
|---|---|---|
| Any nicotine replacement | No nicotine replacement | 50 to 60% more likely to quit |
| A patch | Gum, a lozenge or a spray | The same chance of quitting |
| A patch plus a fast-acting product | One type alone | 17% to 37% more likely to quit |
Sources: Cochrane: NRT; Cochrane: types of NRT
NICE agrees. It says a patch used without a fast-acting product is less likely to work.
So ask your pharmacist for both at once.
Which nicotine patch strength should I start on?
The NHS says if you’re a heavier smoker, you should start with a higher strength. One UK patch leaflet sets this out in three steps.
| Step | Strength | Who starts here |
|---|---|---|
| Step 1 | 21 mg | More than 20 cigarettes a day. Use it for 3 to 4 weeks. |
| Step 2 | 14 mg | Under 20 a day. Use it for 3 to 4 weeks. |
| Step 3 | 7 mg | Nobody starts here. Use it for the last 3 to 4 weeks. |
Sources: UK patch leaflet (eMC); NHS
In trials, 21 mg patches helped more people quit than 14 mg ones. Going up to 42 mg showed no clear extra help.
Brands use different weeks, so follow your own pack. Never cut a patch to lower the dose, and never wear two at once.
24-hour or 16-hour? A 24-hour patch helps with cravings when you wake up. A 16-hour one is for while you’re awake.
Looking for the best brand? We found no trial that ranks one above another. Pick the strength that fits how much you smoke, and ask a pharmacist if you’re unsure.
Can I get nicotine patches free?
In Scotland, yes. NHS inform says NRT is free to everyone from a community pharmacy, stop smoking adviser or GP.
In England, a prescription costs £9.90 per item, unless you get free prescriptions. You can also buy patches in pharmacies, supermarkets and some other shops.
Your local Stop Smoking Service is free. It makes patches easy and affordable to get. The NHS says its help can boost your chances of quitting by 3 times.
What happens at a Stop Smoking Service
- 1
Get referred
Ask your GP or pharmacist, or call 0300 123 1044 in England.
- 2
First session
Pick a quit date and do a breath test.
- 3
Each meeting
Get a supply of, or prescription for, your patches.
- 4
Keep going
Support usually lasts up to 12 weeks.
Source: NHS
In Scotland, call Quit Your Way on 0800 84 84 84. In Wales, call Help Me Quit on 0800 085 2219.
How to use a nicotine patch
Six steps for your patch days
- Have your patches ready to start the day before your quit day.
- Stick it on clean, dry, hairless skin, such as your upper arm, back, chest or hip. Avoid red, broken or sore skin.
- Use a new spot each day, and wait 7 days before you use the same spot again.
- Press the edges down. You can bath, shower or swim with it on.
- Use your gum, lozenge or spray just before the time you’d usually smoke.
- Fold the old patch in half, sticky side in, and keep it away from children.
Sources: UK patch leaflet (eMC); NICE NG209
If a child chews or swallows a patch, contact a doctor or A&E straight away.
Itchy, red skin under the patch is very common. It’s usually caused by using the same spot, so move it each day. If it does not go away, stop and ask your pharmacist about a different type of nicotine replacement.
Poor sleep and odd dreams are very common too. A 16-hour patch is one you take off at bedtime, so ask your pharmacist if it would suit you. More help: falling asleep faster.
Feel sick, dizzy, shaky or sweaty, or notice an uneven heartbeat? You may have too much nicotine. Take the patch off, wash the skin with water, not soap, and contact a doctor, pharmacist or A&E straight away.
Always smoke with your coffee or on a break? Plan your fast-acting product for that moment. See how habit cues work.
Coming off nicotine patches
The NHS suggests using NRT for about 12 weeks, or as long as you need it to stay off cigarettes. When you feel ready, cut the dose down slowly and stop.
Stepping down from a 21 mg patch
- 1
First 3 to 4 weeks
21 mg patch, plus a fast-acting product.
- 2
Next 3 to 4 weeks
Drop to 14 mg.
- 3
Last 3 to 4 weeks
Drop to 7 mg, then stop.
Sources: UK patch leaflet (eMC); NHS
Started on 14 mg? Skip the first step.
Still on patches after 12 months? Talk to a pharmacist, nurse or GP.
Thinking of a vape? The NHS says you’re roughly twice as likely to quit with a nicotine vape than with patches or gum. See vaping to quit.
Nicotine pouches are not licensed stop smoking products in the UK. More in our nicotine pouches guide. If you want help to quit, the NHS says to use one of the licensed products, like patches or gum.
When to speak to a GP
The NHS says NRT is safe and proven to work. Talk to a GP or pharmacist before you start if:
- You have heart problems, such as a recent heart attack, an uneven heartbeat or angina (chest pain caused by your heart), or you’ve had a stroke. The patch leaflet asks you to check first.
- You have diabetes. Check your blood sugar more often when you start, as your medicine needs may change.
- You take clozapine or olanzapine (for some mental health conditions), theophylline (for asthma or COPD) or warfarin (a blood thinner). NICE says doses may need adjusting when you stop smoking.
- You’re pregnant or breastfeeding. Speak to a midwife, GP, pharmacist or stop smoking adviser first. If you’re pregnant, wear a patch for no more than 16 hours in any 24, taking it off at bedtime.
- You’re under 18. NICE says to consider NRT from age 12 for young people who smoke and are dependent on tobacco.
Take the patch off and get medical help straight away if you have trouble breathing or swallowing, or a swollen face, lips, tongue or throat. The same goes for a very itchy red rash or raised lumps.
Call 999 for sudden chest pain that does not go away, or pain that spreads to your arm, neck, jaw, stomach or back. Call too for chest pain with sweating, feeling sick, light-headed or short of breath.
Rarely, nicotine replacement can cause palpitations (a racing, pounding or fluttering heartbeat). See heart palpitations. Never stop or change a prescribed medicine without your prescriber.