Nicotine Without the Smoke

Although NRT comes in a half dozen forms, from patches to inhalers, we like the patch for several reasons:

• First, it delivers a steady supply of nicotine through the skin and into the bloodstream for 18–24 hours
• Second, it doesn't give users the buzz they may feel from gums and lozenges.
• Third, it's the easiest form to stop using when you've completed the program.
• Fourth, inhalers and nasal sprays replicate the smoking process (bringing nicotine from hand to face), and we don't want to encourage that.

How Much, How Long

Patches come in doses ranging from 7 to 22 milligrams (mg). The starting dose depends on how much you smoked before your quit day. Use this formula as a guide: One cigarette = about 1 mg of nicotine. For the first few weeks, use a daily patch (or combo of patches) that delivers about the same amount of nicotine you're used to inhaling. For example:

• Pack-a-day smokers can use a 22 mg patch each day for about two months, and then go down to 14 mg for 2 months, then to 7 mg for 2 months.
• Very heavy smokers may need to begin with two 22 mg patches a day and gradually cut down over 9 months.
• Very light smokers may find that an occasional piece of nicotine gum or a nicotine lozenge is all they need.

Nicotine replacement is not a one-size-fits-all therapy, so you may need a bigger or smaller dose than we've suggested. Talk with your doctor to find what works best for you.

For bumps in the quitting road -- those mind-over-body moments when, despite the patch's steady supply of nicotine, you want a cigarette -- try a piece of nicotine gum or a lozenge for a small extra dose.