Quitting smoking can be tough. In addition to having to break the psychological part of the habit, you also have to deal with nicotine addiction. Getting off of nicotine is a difficult process no matter what, and it can be so brutal if you take the abrupt “cold turkey” method that many smokers just can’t get through it. Nicotine replacement methods can help smokers kick the habit by allowing them to step down on the amount of nicotine they consume.
How it Works
That’s where the concept of the nicotine patch comes in: the patches stick on to your skin and you absorb the nicotine through your skin, into your bloodstream. This method, called transdermal, releases nicotine into your system as a replacement for smoking.
The nicotine patches have a pad that contains the nicotine, which is covered by a layer of plastic and made to look like a bandage. The patches are extremely sticky and stay in place for most of the day, and will usually not come off even if you bump against them. In general, they are designed to be worn for 24 hours and deliver a specific amount of nicotine over that period.
The beginning dosage of a nicotine patch roughly correlates to how heavily you smoked, so that it will provide an initial adequate replacement for the nicotine you consumed in cigarettes. The strengths range from 7 mg to 21 mg. The intention is that after some time, your body will require less nicotine and you can step down to a lower strength until you are gradually able to taper off the nicotine replacement patches altogether.
Product History
The first nicotine transdermal system on the market was NicoDerm CQ, which was introduced by the manufacturer GlaxoSmithKline and was approved in 1991. At first, NicoDerm was only available with a doctor’s prescription. However, the U.S. Food and Drug Administration changed the product’s status in 1996 to make it available over the counter without a prescription.
Eventually generic versions of the nicotine patch became available, which significantly lowered the cost of the products. However, the original brand name manufacturers still promote that their products have advantages over the generics because they have stickier adhesive and clear plastic layers that are less obtrusive and match more skin tones.
Side Effects
Although nicotine patches are considered safe, they are still a drug and therefore can have negative side effects on your health. Some of the most common side effects associated with nicotine patches include skin irritation, itching, nausea, dizziness, headaches, anxiety and insomnia. Transdermal nicotine patches can also make you feel like your heart is racing.
Side effects seem to be the worst at higher doses, so you may want to switch to a lower dose patch if you experience intolerable negative side effects.
Product Warnings
Like any drug, whether prescription or over the counter, transdermal nicotine replacement patches can present some risks. It’s important to be aware of those risks so that you can try to minimize damage from them.
Nicotine replacement patches also contain tobacco-specific nitrosamines, or TSNAs. These compounds are produced during the curing and processing of tobacco and are found in any form of tobacco, including cigarettes and dipping tobacco (also called snuff.) These TSNAs are strongly linked to causing cancer, including cancers of the lungs, pancreas, mouth and esophagus. So at least in this specific sense, nicotine patches are not safer than smoking.
Diabetics and people with insulin resistance and other pre-diabetic symptoms should use caution as well. Nicotine in any form increases your blood sugar levels, which can make diabetes control much worse. Check with your doctor before using nicotine replacement patches if you are diabetic.
Nicotine patches also present the very serious risk of nicotine overdose. Children may be at extra risk of nicotine overdose because the patches seem very similar to other safer items like stickers. You may also be at risk of nicotine poisoning or overdose if you use nicotine replacement products while continuing to smoke or in addition to other nicotine replacement products, like gum or lozenges. Transdermal nicotine patches deliver a very concentrated amount of nicotine to your bloodstream and they are a very powerful form of medicine. When combined with the nicotine in cigarettes, it could be enough to cause overdose symptoms, such as nausea and vomiting, high blood pressure, seizures, respiratory failure and even death.
Success Rates
Even though nicotine replacement patches have side effects and some risks, for many people the benefits far outweigh the risks. Dozens of clinical trials proved the efficacy of the nicotine patch, with success rates of nearly double that of placebo.
Nicotine patches may have additional uses for purposes other than quitting smoking, as well. Researchers are studying the possibility that nicotine patches may treat early dementia and relieve post-surgical pain. Nicotine patches may also help with symptoms related to ulcerative colitis; however, nicotine in any form can actually make symptoms related to Crohn’s disease much worse, and the similarities between these two conditions mean that you should not attempt to self-medicate. Always seek a doctor’s advice if you are using transdermal nicotine patches for any purpose, but particularly when doing so off label to treat other conditions.
Studies are also being done to see if nicotine will help with mental conditions such as depression, anxiety and attention deficit hyperactive disorder (ADHD), as well as Alzheimer’s and Tourette’s syndrome. Nicotine appears to boost concentration, whether you receive nicotine in the form of the transdermal patch or through smoking. The risks from nicotine, particularly related to increased cancer odds, mean that nicotine patches should not be considered benign or harmless, but that researchers may someday find safe ways to use them.
Transdermal nicotine replacement therapy can be a very effective way to help you quit smoking once and for all. However, the patches need to be treated with caution and kept out of the reach of children, and should definitely not be used if you are continuing to smoke.