Using Nicotine Patch Before Quit Date Ups Success

The smoker switches to a lower-strength patch after being on the original one, perhaps after the first two weeks, and then uses the patches from six to 20 weeks, depending on the instructions.

Side effects aren't common but can include dizziness, vomiting, redness at the patch site or upset stomach, according to the U.S. National Institutes of Health. Smokers are advised to check with their doctors about how best to use the patches and to alert doctors to symptoms such as abnormal heartbeat or difficulty breathing.

The patches deliver a low but continuous level of nicotine that helps quell cravings, according to the FDA. But, "when delivered through the nicotine patch it is not addictive," said another expert, David Kalman, an assistant professor of psychiatry at Boston University.

"What makes nicotine addictive is pretty much what makes any drug addictive, and that has to do with the mode of delivery," he said. "When you smoke, it gets into the arterial blood stream and goes immediately to the brain in a large dose." However, when delivered via the patch, nicotine "enters the venous system and doesn't go immediately to the brain," Kalman said.

Based on studies in the literature, Kalman said, "about five in 100 [users] quit on a given quit attempt" if they do it "cold turkey," without medication, counseling or other help.

Adding the nicotine patch bumps that quit-success rate up to 20 percent to 25 percent, he said. "Success" is defined as not smoking one year later.

While patches come in various doses, Kalman's research found no significant differences in quit rates of smokers who used 21 milligram patches vs. 42 milligram patches.

His study focused on smokers who also had alcohol dependence and was published in the April 2006 issue of theJournal of Substance Abuse and Treatment. A 21-milligram patch is roughly equal to about 15 cigarettes a day, while a 42-milligram patch corresponds to 30 cigarettes, he said.

Kalman said those who opt for the patch to help them quit should use it for at least eight weeks. Patience is key, he said.

"Years and years of smoking produces changes in the brain. When you stop smoking, it takes time for the brain to readjust," Kalman said.

More information

To learn more about the dangers of cigarette smoking, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Jed Rose, Ph.D., medical research professor, director, Center for Nicotine and Smoking Cessation Research, Duke University Medical Center, Durham, N.C.; David Kalman, Ph.D., assistant professor, psychiatry, Boston University; Feb. 1, 2006,Nicotine and Tobacco Research; April 2006,Journal of Substance Abuse and Treatment