Nicotine patch
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- NicoDerm CQ Step 1 patch, 21 mg. Best for: People who smoke more than 10 cigarettes a day. See options on Amazon
- NicoDerm CQ Step 2 patch, 14 mg. Best for: 10 or fewer cigarettes a day, or stepping down. See options on Amazon
- NicoDerm CQ Step 3 patch, 7 mg. Best for: The final weeks. See options on Amazon
Which step to start on
| Step | Patch strength | More than 10 cigarettes a day |
|---|---|---|
| Step 1 | 21 mg over 24 hours | Weeks 1 to 6 |
| Step 2 | 14 mg over 24 hours | Weeks 7 to 8 |
| Step 3 | 7 mg over 24 hours | Weeks 9 to 10 |
Details are from the NicoDerm CQ DailyMed label. If you smoke 10 or fewer cigarettes per day, do not use Step 1: start with Step 2 (14 mg) for 6 weeks, then Step 3 (7 mg) for 2 weeks, and then stop.
How to apply the patch
- Begin on your quit day.
- Apply one new patch every 24 hours on skin that is dry, clean and hairless.
- Remove the backing and immediately press the patch onto skin; hold for 10 seconds.
- Wash your hands after applying or removing a patch.
- Put each new patch on a different skin site at the same time each day.
Do not wear more than one patch at a time, do not cut it, and do not leave it on for more than 24 hours, because it may irritate your skin and loses strength after 24 hours.
16 hours or 24 hours?
The label says you may wear the patch for 16 or 24 hours. If you crave cigarettes when you wake up, wear it for 24 hours. If you have vivid dreams or other sleep disturbances, you may remove the patch at bedtime and apply a new one in the morning.
Steps 2 and 3 let you gradually reduce your nicotine, and the label says completing the full program will increase your chances of quitting successfully. If you feel you need the patch longer, talk to your health care provider.
Who should ask first
- Ask a doctor before use if you have heart disease, a recent heart attack or irregular heartbeat, high blood pressure not controlled with medication, a stomach ulcer or diabetes, or a history of seizures. The labels note nicotine can increase heart rate and blood pressure.
- Ask a doctor or pharmacist if you use a non-nicotine stop smoking drug, or take a prescription medicine for depression or asthma, since your dose may need to be adjusted.
- Pregnancy or breastfeeding: the labels say only use nicotine replacement on the advice of your health care provider, and try to quit without it first.
- Skin: ask a doctor first if you have an allergy to adhesive tape or skin problems, since you are more likely to get rashes.
- Under 18: ask a doctor before use.
Skin reactions and safety
Stop use and ask a doctor if skin redness caused by the patch does not go away after four days, or if your skin swells or you get a rash. Stop use and ask a doctor if irregular heartbeat or palpitations occur, or you get symptoms of nicotine overdose such as nausea, vomiting, dizziness, weakness and rapid heartbeat, or signs of an allergic reaction such as difficulty breathing or rash. In case of overdose, get medical help or contact a Poison Control Center right away.
Used patches still contain enough nicotine to poison children and pets, the label warns. Dispose of a used patch by folding the sticky ends together, putting it back in its pouch and throwing it away.
Patch vs gum vs lozenge
The patch gives steady nicotine with one application a day, which suits people who want a simple routine. Gum and lozenges let you respond to sudden cravings; see our nicotine gum guide and nicotine lozenge guide.
Free help improves the odds. The CDC lists 1-800-QUIT-NOW (1-800-784-8669) for free quitline coaching over the phone, and links to guides on all the main quit medicines: the nicotine patch, gum, lozenge, oral inhaler and nasal spray, plus varenicline and bupropion SR, which need a prescription. Ask a pharmacist or doctor which option, or combination, fits you.
What to look for when you buy
NicoDerm CQ Step 1 patch, 21 mg
Best for: People who smoke more than 10 cigarettes a day
The label starts heavier smokers on 21 mg patches for weeks 1 to 6.
Watch out: Do not wear more than one patch at a time.
See options on AmazonNicoDerm CQ Step 2 patch, 14 mg
Best for: 10 or fewer cigarettes a day, or stepping down
The label uses 14 mg as the start for lighter smokers and the step-down for others.
Watch out: Rotate skin sites each day.
See options on AmazonNicoDerm CQ Step 3 patch, 7 mg
Best for: The final weeks
The label uses 7 mg for the last 2 weeks before stopping.
Watch out: Fold used patches and discard safely.
See options on AmazonQuestions people ask
- Which nicotine patch strength should I start with?
- 21 mg if you smoke more than 10 cigarettes a day; 14 mg if 10 or fewer, per the label.
- How long do you use nicotine patches?
- The label's plan runs 10 weeks for heavier smokers and 8 weeks for lighter smokers.
- Can I sleep with a nicotine patch on?
- Yes, unless you get vivid dreams or sleep problems; then remove it at bedtime and apply a new one in the morning.
- Where should I put a nicotine patch?
- On clean, dry, hairless skin, at a different site each day.
- Can I cut a nicotine patch in half?
- No. The label says do not cut the patch.
Sources
- NicoDerm CQ (nicotine) patch label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine
- How to Quit Smoking (cdc.gov), Centers for Disease Control and Prevention