Posted on Sep 6, 2011 in Health & safety
Is the nicotine patch really the best tool to use to quit smoking? How do they work exactly?
There are so many ways to quit smoking, and the nicotine patch is one of the most successful methods out there! New York Health Commissioner Dr Thomas R Frieden says, “Quitting isn’t easy, but nicotine replacement can double your chances of success.”
Nicotine patches are a transdermal (meaning through the skin) drug delivery method created to help to people stop smoking. The patches contain nicotine, and release a certain amount as the day goes by. This helps you keep your cravings at bay because there is a continual stream of nicotine flowing into your body.
If you take a look in your local drugstore or online, you will notice a wide array of nicotine patches by brand and by steps. Before you choose, however, talk with your primary healthcare provider to make sure you choose the dose that’s correct for your weight and your smoking habit. (If it’s prescribed, some insurance companies will even cover the cost of the nicotine patch.)
For smokers who go through a pack or more per day, the typical timing is to begin with step one patches as they contain the highest amount of nicotine in them (21mg). Stay on the step one patches for weeks 1 – 4. Next move down to step 2 (14mg) and stay on those during weeks 5 and 6. Finally, use step 3 (7mg) for weeks 7 and 8. At the end of this process, the hope is that you will be smoke-free,
Research from the University of Pennsylvania School of Medicine, however, has found that extended use of a nicotine patch — 24 weeks (about six months) versus the standard eight weeks — may help some people stay away from the cigarettes for longer. The study authors noted, “Our data suggest that the many smokers who relapse while trying to quit will be especially helped by extended treatment, which appears to make it easier for smokers to ‘get back on the wagon’ after a small smoking slip, instead of having it turn into a full-blown relapse.”
You typically wear each patch for anywhere from 16-24 hours before changing it out. But where’s the best place to attach your little therapeutic square?
Typically, hairless spots — including the chest, hip or outside of the upper arm — are the spots where you’re told to stick your patch. However, it may be helpful to keep in mind what some students at Cornell learned when they conducted a study of the effects of placing the nicotine patch in different locations on the body. They wrote, “The results showed that the placement of the patch on the body is relevant and that the epidermal layer of the skin is the biggest barrier to transdermal drug delivery. For faster delivery directly to blood it is useful to use an area of the body with a thin epidermal layer; but for a more time-consistent delivery to the blood, a thicker epidermal layer is preferable.”
It is suggested that you rotate adhesion sites each time to avoid skin irritation, and don’t re-use the same site for seven days.
Cosmetically, the patch is not an attractive accessory. The good news is that you can wear the patch in most any place on your skin, and you can get a clear patch as well!
No matter which you choose, there is always the issue of that icky guck that is left behind when you take it off. The best way I have found to get rid of this is by using rubbing alcohol. The individual alcohol wipes work best — but no matter how you apply the alcohol, it really does the trick.
Finally, when you’re done with each patch, dispose of it carefully — nicotine can be toxic to kids and animals. Stick it on a napkin or piece of paper and be sure it’s placed well into the trash (but if you have inquisitive children or pets, you might need to take additional steps to ensure their safety).
Sound good? Well, also know that there are specific rules you need to follow, and some possible side effects.
The main side effect noted by users is itching and burning at the site of the patch. This usully only lasts for an hour at the most, and can be alleviated by slapping the spot the patch is on. (Yes, it does sound odd to slap yourself, but you cannot actually scratch it without pulling the patch off — or if you scratch around the edges, you risk loosening the adhesive and making the patch fall off.) Aside from the initial annoying itch and burn, there may also be some redness around the area where you wore the patch, and even some very slight swelling. These are not typically bad enough for people to stop using the patch, though.
A 2001 study published in the medical journal Addiction found that the patch also made some participants experience abnormal dreams (3.3%), headaches and rash (3.2%) and insomnia (2.5%).
In addition to these minor side effects, other more bothersome and even serious effects have been noted. Use of the patches has been connected to dizziness, nausea and vomiting. The more serious (and less-common) adverse effects that have been noted include an allergic reaction to the patch adhesive, seizures and shortness of breath. These are potentially serious, so if they occur, stop using the patch immediately and get to a medical professional! Also be mindful of any medications you take on a regular basis, and find out if the nicotine patch will interact with any of them before beginning use. Your doctor or pharmacist can provide this information.
The single most important rule about using the nicotine patch is DO NOT SMOKE while using it. This also means do not decide that you must smoke, take off the patch, and light up. This can still cause a nicotine overdose.
“Your body doesn’t care where the substance [nicotine] is coming from, and the extra dose could affect your blood pressure,” notes Thomas H. Lee, MD, the Editor-in-Chief of the Harvard Heart Letter. “If you have heart disease it could do much more — smoking while using a nicotine patch has led to heart attacks in some people.”
How do you know if you have overdosed? The main symptoms are cold sweats, heart palpitations, fainting, confusion, and blurred vision. If you think you are suffering from an overdose, remove the patch and get medical help ASAP.
I have personally used this product with great success, and have some tips to offer any patch users or potential patch users.
First, keep a bottle of water around. I have found that during the first few hours of applying a new patch that my thirst level skyrockets. This has to do with the initial high dose of nicotine being introduced into your system. (As a smoker, you have probably noticed your thirst increase and your mouth dry out after smoking too many cigarettes in a short period of time. It’s the same principle.)
It has also been my experience that the best time of the day to put on the patch is first thing in the morning. There are two reasons for this. 1.) Most smokers reach for a cigarette upon waking, so putting on the patch when you wake up can help stop the craving before it hits too hard. 2.) The one time I changed my patch before bedtime, I became violently ill. I woke up feeling drunk! After being sick for a few minutes, my mind cleared enough to remember that I had not had anything alcoholic to drink the night before. I was dizzy and vomiting and having cold sweats. While these are also signs of overdose, I had used the product correctly so I was fairly sure that was not the case. The only thing I can attribute that episode to is the timing.
If you are serious about quitting and want to give the patch a shot you, can get more information by going to the NicoDerm CQ or Habitrol sites to get specifics about their products.
Be sure to set a quit date, and good luck on your journey to better health!
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