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Relieves and/or prevents craving and nicotine withdrawal symptoms associated with tobacco dependence. It is indicated to aid smokers wishing to quit or reduce prior to quitting, to assist smokers who are unwilling or unable to smoke, and as a safer alternative to smoking for smokers and those around them. It is indicated in pregnant and lactating women making a quit attempt. If possible, the patch should be used in conjunction with a behavioural support programme. Application should be limited to 16 hours per day.
Smoking cessation: Adults over 18 years who smoke 10 or more cigarettes a day; start on the 25mg patch (Step 1), and use one patch daily for 8 weeks. Gradual weaning from the patch should then be initiated. One 15mg patch (Step 2) should be used daily for 2 weeks followed by one 10mg patch (Step 3) daily for 2 weeks.
Lighter smokers (i.e. those who smoke less than 10 cigarettes per day) are recommended to start at Step 2 (15mg) for 8 weeks and decrease the dose to 10mg (Step 3) for the final 4 weeks.
Those who experience excessive side effects with the 25mg patch (Step 1) which do not resolve within a few days should change to a 15mg patch (Step 2). This should be continued for the remainder of the 8 week course, before stepping down to the 10mg patch (Step 3) for 4 weeks. If symptoms persist advice from a health professional should be sought.
Adolescents 12-18 years: as per adults, but the recommended treatment duration is 12 weeks. Smoking reduction/pre-quit: smokers are recommended to use the patch to prolong smoke-free intervals and with the intention to reduce smoking as much as possible. The starting dose should follow the smoking cessation instructions (see above).
Smokers starting on the 25mg patch should transfer to the 15mg patch as soon as cigarette consumption reduces to less than 10 cigarettes per day. A quit attempt should be made as soon as the smoker feels ready. When making a quit attempt smokers who have reduced to less than 10 cigarettes a day are recommended to continue Step 2 (15mg) for 8 weeks and decrease the dose to 10mg (Step 3) for the final 4 weeks.
Temporary abstinence: the patch can be used in those situations where smokers cannot or do not want to smoke for prolonged periods (greater than 16 hours).
For shorter periods an alternative intermittent dose form would be more suitable (e.g. Nicorette Inhalator or gum). Smokers of 10 or more cigarettes per day are recommended to use the 25mg patch and lighter smokers (those who smoke less than 10 cigarettes per day) the 15mg patch. Under 12 years: not recommended.
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