The Scoop On Smoking from ACSH: what every teen should know about tobacco
nicotine patch (habitrol, nicoderm CQ, nicotrol)treatment type: drug
availability: over the counter (for 18 and over)
treatment duration: 8-16 weeks
dose: various doses for both 16 hour and 24 hour patches
cost per day: $4.00
for comparison, calculate how much you currently spend on tobacco products per day
Information about Nicotine Replacement Therapy on this website is based on data on adults only. The safety and efficacy of NRT for teens has not been sufficiently evaluated in order for the FDA to approve it for use for those under 18. However, clinical practice guidelines by the U.S. Public Health Service advise that physicians can consider prescribing NRT to those under 18 'when there is evidence of nicotine dependence and a desire to quit tobacco use.'(6) Before receiving a prescription for NRT, a teenager must be carefully evaluated by a doctor in order to determine whether they may benefit from using NRT, and whether the potential benefits of using it outweigh the potential risks.
Regardless of your age, it is always wise to consult a health care provider before beginning a smoking cessation program.
The nicotine patch, or transdermal nicotine, is a self-adhesive strip that is applied to the skin and releases nicotine into the outer layer of the skin in various doses and intervals. The nicotine in the patch may take as long as three hours to be absorbed through the skin and into the bloodstream. Thus, the patch must be worn for extended periods of time so that the user maintains a constant blood level of nicotine. The patch was introduced in 1992 and is available by prescription or over the counter through three major brands. Generic patches are also available.
The 24-hour patch is available in 21 mg, 14 mg, and 7 mg doses, depending on the brand (generic brands have additional doses). A new patch is applied to the skin each morning, usually on the abdomen between the neck and the waist or on the upper arm or shoulder, and the location of the patch should be periodically rotated. According to manufacturers, the patch should be used for 4 to 10 weeks; however, studies show that treatments of 8 weeks duration work as well as longer treatments.(6)
Highly dependent smokers, or those smoking more than 10-15 cigarettes per day, should begin with the highest possible dose and may opt initially for the 24-hour patch. Less dependent smokers, or those smoking fewer than 10 cigarettes per day, should start with a lower dose. Manufacturers also recommend, in general, starting with a higher dose and then tapering over 2-4 months. For example, the recommended taper is 21 mg for 4 weeks, then 14 mg for 2 weeks, and finally 7 mg for 2 weeks. The 16-hour patch comes in doses of 15 mg, 10 mg and 5 mg. It should be applied in the morning and removed before bedtime. The recommended duration of treatment is 8 weeks.(6) The average cost of the patch is $4.00 per day, or about $30.00 for a one-week supply.
In a fashion similar to other NRTs, patch use can double long-term quit rates compared to placebo.(6) There are several advantages of the patch, including: it is very easy to use; it comes in various doses, so the user can taper the dose as progress is made; it need only be used once a day to provide a continual stream of nicotine; and it is inconspicuous. One disadvantage to the patch is that it releases nicotine more slowly than other NRTs do and therefore cannot be used to combat sudden nicotine cravings.
There are minimal side effects associated with the patch. The main side effect is a localized rash and skin irritation many users develop from the actual patch -- approximately 50% of users experience such a reaction, but less than 5% actually have to stop using the product.(6) Users can treat these reactions with hydrocortisone or triamcinolone cream and rotate the location of the patch as recommended. Further, people with existing skin conditions, such as eczema, or with allergies to adhesives should be cautious about using the patch and consider alternative NRTs.
Another potential side effect from the nicotine patch is sleep disturbance. This usually occurs in those using the 24-hour patch, because users are unaccustomed to having nicotine in the system while asleep. This can produce insomnia. Sleep disturbance can be prevented by using the 16-hour patch or by removing the 24-hour patch during sleeping hours. However, taking the patch off at night can leave the user with an intense cigarette craving first thing in the morning.
The American Council on Science and Health is a consumer eduction consortium with a board of 350 physicians, scientists, and policy advisors.