Nicotine patches are the workhorse of NRT. They deliver steady nicotine through the skin, blunting the withdrawal that peaks on days 2-4, and freeing you to focus on the behavioural side of quitting.
Choosing your strength
Patches come in 21 mg, 14 mg, and 7 mg per 24 hours (or 25 mg, 15 mg, 10 mg per 16 hours in the UK).
| Daily vape habit | Start on |
|---|---|
| 20 mg/mL disposable, ~1/day | 21 mg |
| Juul-a-day (50 mg/mL pod) | 21 mg |
| Low-strength refillable (3-6 mg/mL) | 14 mg |
| Half a disposable a day | 7-14 mg |
| Multiple disposables a day | 21 mg + clinician review |
If you get nausea, headaches, or a racing heart, drop a step. If cravings break through every hour, add a short-acting form (gum or lozenge) rather than stacking patches without clinician oversight.
16-hour vs 24-hour
- 24-hour patch: covers the morning craving reliably. Can cause vivid dreams or sleep disruption in a minority of users.
- 16-hour patch: worn during waking hours only; better sleep, but a stronger morning craving on waking.
Try 24-hour first; switch to 16-hour if sleep suffers.
Wearing patches
- Apply to clean, dry, hairless skin on the upper arm, upper back, or upper chest.
- Press firmly for 10 seconds.
- Rotate site daily. Do not reuse the same spot for at least a week.
- Wash your hands after applying.
- Do not cut patches; the adhesive matrix makes dosing unreliable.
Stepping down
The standard schedule:
- Weeks 1-6: 21 mg
- Weeks 7-8: 14 mg
- Weeks 9-10: 7 mg
- Week 11+: off, keep short-acting form on hand
Stopping early is one of the top reasons quits fail in week three or four. Follow the schedule even if you feel done sooner.
Side effects
- Skin irritation at site (rotate; low-strength hydrocortisone if needed).
- Vivid dreams (switch to 16-hour).
- Mild headache (usually resolves in first week).
Stop and see a clinician for palpitations, severe rash, or persistent nausea.
When patches are not enough
Combine with a short-acting form for cravings, or consider a prescription medication. See combining NRT for the protocol.
