The Nicotine Patch
What Is It?
The patch is a self adhesive, nicotine-containing circle that looks like an
oversized band-aid. The outer ring sticks to the skin, while the inner portion
presses against the skin and slowly releases nicotine into the outer layer of the skin.
Unlike smoke, which passes almost instantaneously into the blood through the linings
of the lung, the nicotine in the patch takes up to three hours to make its way through
the layers of skin and into the user's blood. This method allows the user to achieve a near
constant level of nicotine in their system. For this reason the patch must be worn all
day, and cannot be put on and removed as a substitute for a cigarette.
Warnings, Cautions and Various Nasty Possibilities
The FDA and the manufacturers of the patch warn very strongly against smoking while
on the patch, as it could result in more nicotine in the user's system than they are
prepared to handle. While actual cases of this are extremely rare, it is not worth the
risk. Remember as well that nicotine continues to enter the bloodstream for several
hours after removing the patch, as it leaches through the skin, so smoking within 12
hours of removing the patch is strongly discouraged.
The two most common side effects of the patch are a localized skin rash and sleep
disturbance. Read the literature that comes with medication carefully and follow the manufacturer's
directions in case of any problems.
The rash generally has one of two causes, a reaction to the adhesive on the patch, or
a reaction to the nicotine. Use of a topical salve (such a hydrocortisone cream) can
usually relieve some of the discomfort.
Sleep disturbance almost always occurs in people who use the twenty-four hour patch.
Since your mind is unaccustomed to receiving it while asleep, nicotine can cause strange
effects, including vivid, colorful dreams and difficulty sleeping. Switching to the 16-hour
patch helps avoid this problem, but it often can leave the user craving a cigarette when they
wake in the morning.
Remember to treat any nicotine-containing product with respect. While both the patch
and the gum eliminate most of health risks associated with tobacco use, nicotine itself
can cause serious medical problems, including death, if abused.
Using the Nicotine Patch
The patch is designed to be applied to a clean, hairless place on your skin. Most
people favor the upper arms or the shoulders, there is however no reason not to use your
other locations, such as the legs, thighs or forehead.
Make sure you read and follow the directions enclosed with the medication, as well as
any given to you by your doctor. One point, often overlooked, is that the patch shouldn't
be applied to the same location over and over again. Find several locations and rotate
between them; this should decrease any problems with skin irritation you might have.
To help you determine if the patch is right for you, consider using the QuitNet
Medication Wizard.
More medically specific information ...
Content author:
Alan S. Peters, CTTS-M
Reviewed by:
Andy Perez, MD, MBA, FACEP, February 2009
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