Nicotine Patches
The most successful strategies for quitting are those that combine a behavior modification plan (changing the "habit" part), with a pharmacological aid (nicotine skin patch or nicotine gum) to alleviate the physical craving for nicotine.

You may question that if nicotine is so bad for your health, why would we suggest using the patch?  The nicotine in the patch is absorbed without the combustion of a cigarette, so the bronchial airways are not aggravated.  Also, using the patch instead of smoking eliminates over 4,000 chemicals, including many that cause cancer.  It is easier to give up the nicotine patch than cigarettes.

Nicotine skin patches come in three different strengths:

1. 21 mg (some of the patches are listed as 23 mg, but this is equivalent to 21 mg absorption)
2. 14 mg
3. 7 mg

If you smoke a pack of cigarettes per day or more, the usual recommended program is:  four weeks of the 21 mg patch, followed by four weeks of the 14 mg patch, then two to four weeks of the 7mg patch.

One patch should be placed each morning.  Some people who have tried to place them at night have had difficulty sleeping.  If the patch is too strong, you may also experience vivid Technicolor dreams.  It is common to feel a little light-headed when the patch is first placed, similar to the "nicotine buzz" you may have experienced with your first cigarette.  If, however, you experience prolonged dizziness, irritability, palpitations, headaches or nausea, contact your physician.  The dose of the patch may need to be decreased.  If the strength of the patch is decreased, increase the number of weeks you use it.  The most successful cessation has occurred when the patches are used for a total of 10-12 weeks.

Choose a non-hairy, clean, dry area of your chest or upper arm for placement. Remove the old patch.  Take off the protective liner of the new skin patch and press it firmly to a different area of your skin for 10 seconds.  Wash your hands in case some of the nicotine has gotten on your hands.

The patch may be worn while bathing, showering or working out.  The adhesive should be strong enough for the patch to stay in place.

REMEMBER:  IT IS IMPORTANT NOT TO SMOKE WHEN WEARING THE SKIN PATCH.  You may OVERDOSE on nicotine if you smoke with the skin patch in place.  Even if have decreased to only one to three cigarettes per day, with the skin patch in place you are actually getting more nicotine in a 24-hours period than smoking two packs of cigarettes per day.  You must be ready to quit before you start using the patch. Nicotine patches help to curb some of the unpleasant withdrawal symptoms from nicotine.  They are not magic.  You have to convince yourself to quit. 

DO NOT CUT THE USE OF THE PATCH SHORT!  People who are most successful in using nicotine patches for smoking cessation are those who follow a 10-12 week program.

Nicotine Gum
Some people prefer gum over the patch.  The advantage of the gum is that you have something in your mouth to substitute the oral need from your cigarette.  The disadvantage is that it is more difficult to obtain a steady nicotine level with the gum than the patch.

As with the patch, DO NOT COMBINE CIGARETTE SMOKING WITH USE OF NICOTINE GUM!  The nicotine gum is available in 2 mg or 4 mg (double strength).  When using the gum, chew it slowly until until a tingling or peppery taste is in your mouth (usually about 15 chews). Then "park" the nicotine gum between your cheek and gum.  This allows the nicotine to be absorbed through the lining of your mouth and into your bloodstream.  Start to chew the gum again when the  peppery taste or tingling returns, park the gum in a different spot between your cheek and gum.  Repeat this until most of the nicotine is gone (usually about 30 minutes).

Most people find that nine to 12 pieces of gum per day will control the urge to smoke.  DO NOT USE MORE THAN 20 PIECES OF THE 4 mg (double strength) GUM OR MORE THAN 30 PIECES OF THE 2 mg STRENGTH PER DAY.

As the urge to smoke decreases, gradually use fewer pieces of nicotine gum. Slowly decrease over 2-3 months.  Every 4-7 days, you can reduce the number of pieces of gum per day by one.  For example, if you are using 12 pieces a day, begin using 11 pieces after 4-7 days.  The 4-7 days later, use 10 pieces per day.  You may also begin to decrease the time you use the gum.  Use some pieces for only 10-15 minutes instead of 30 minutes.  Keep decreasing the number and length of time you use the gum over 2-3 months until you are completely free of nicotine.

Click here to find out about Smoking Cessation Classes offered at Baptist Regional Medical Center.