Nicotine Patch in Canada: Types, Cautions and Use Length

Most nicotine replacement products work in short bursts, and the patch is the exception. Health Canada says patches are the only available long-acting form, giving a steady dose while they are on. This page collects what HealthLinkBC, Health Canada and the BC PharmaCare program say about patches, and it is general information only. A pharmacist or doctor can answer questions about your own situation.

What is a nicotine patch?

HealthLinkBC describes it as a patch that looks like a large bandage. The outer part sticks to your skin, and the inner part presses against the skin and slowly releases nicotine into it. Our guide to nicotine replacement products in Canada covers all the forms side by side, while the gum page covers the short-acting kind you might use alongside a patch.

HealthLinkBC says patches may give a constant dose for either 16 or 24 hours. Health Canada says a typical routine is to put one on in the morning, wear it day and night, and replace it the next morning.

How do the sources say to wear it?

HealthLinkBC lists these points:

1. Read the directions that came with the product, and any your doctor gave you.
2. Choose the strength with a doctor or pharmacist. The starting size depends on how much you smoke now.
3. Apply it to a clean, hairless spot between your neck and waist, such as the upper arm, shoulder or back.
4. Rotate between several spots, because using the same one over and over can irritate the skin.
5. Change it every day and wear it all day. Do not take it off to smoke, and do not use it on and off in place of a cigarette.

The page says many brands step down from large patches for the first few weeks, to medium for the next few, then to the smallest for the last few weeks. Other brands use the same size every week and then simply stop. It gives no mg figures for those steps. A separate HealthLinkBC page says people who smoke heavily do better with patches of 21 mg or more.

How long do people use it?

HealthLinkBC says patches are usually used for 8 to 10 weeks, but that it varies with each person and the brand. If you feel you need them longer, it says to talk to your doctor. In British Columbia, PharmaCare covers one continuous course of up to 12 weeks (84 days) a year, which is a coverage rule and not a recommended length.

What side effects and cautions do the sources list?

HealthLinkBC says patches can cause itching and redness where you put them, and that rotating spots helps with irritation. It also says the 24-hour type may cause trouble sleeping or unusually vivid dreams, and that removing the patch a few hours before bed may stop this. Its comparison page says all nicotine replacement forms have side effects, and that for most people they are mild and last the first week or two. If you are unsure whether a symptom comes from the patch or from quitting, see nicotine withdrawal symptoms.

On who should check first, the BC program suggests talking to a pharmacist or healthcare provider if you are pregnant or breastfeeding, have a chronic condition such as diabetes, high blood pressure, a heart problem, kidney disease or a breathing issue, or were recently in hospital. Health Canada says that for pregnant or breastfeeding people, short-acting forms are preferred over the patch, and that counselling is recommended first. HealthLinkBC says people under 18 cannot buy the over-the-counter products, though a doctor may prescribe them.

Can you combine it with other products?

HealthLinkBC says experts recommend combining the patch with another nicotine product and suggests talking to your doctor about it. Health Canada says short-acting products can be used alone or with a patch, and that mixing a long-acting and a short-acting form nearly triples the chance of quitting. Prescription options are covered on our medications page.

Where do you get it?

Health Canada calls nicotine replacement therapy an over-the-counter medication, and HealthLinkBC says patches can be bought without a prescription. The BC Smoking Cessation Program says you visit a local pharmacy, both you and the pharmacist sign a declaration form, you do not need a prescription and you can likely get the product the same day. Our pages on pharmacy programs and what is free for me explain what other provinces may offer.

What we could not confirm

• The Health Canada Drug Product Database entries for patches. We did not read them, so strengths come only from the HealthLinkBC pages above.
• Which stores sell patches in each province.
• A full official list of people who should not use a patch. The pages we read give the cautions above and nothing more complete.
• Patch coverage outside British Columbia.