The recommended starting strength for all brands of NRT patch is generally the highest, except for light smokers (defined as fewer than 10 or 20 cigarettes per day, depending on brand), for whom the medium strength should be used first.

The recommended treatment period and length of time on each strength varies between brands, but the overall strategy is a stabilisation period on the high strength for four to eight weeks, followed by a progressive stepping down of strength over a further two to eight weeks, before stopping altogether. The total maximum recommended course is 10 or 12 weeks, depending on brand.

Transdermal patches should be applied daily to a clean, dry, non-hairy area of the trunk or upper arm. The 16-hour patches should be removed at bedtime and a fresh one applied next morning.

To minimise the possibility of localised skin reaction, a new application site should be chosen each day, and several days should be allowed to elapse before a patch is reapplied to the same area. Used patches should be folded in half with the adhesive side inwards and disposed of carefully, because they still contain significant amounts of nicotine – certainly sufficient to poison a child.

As patches can cause localised skin reactions, they should be avoided by patients with any chronic or serious skin condition.