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NRT: Other Considerations NRT is not FDA-approved for use in children or adolescents Nonprescription sales (patch, gum, lozenge) are restricted to adults 18 years of age NRT use in minors requires a prescription Patients should stop using all forms of tobacco upon initiation of the NRT regimen Patch (OTC) Gum (OTC) Lozenge (OTC) Nasal Spray (Rx) Oral Inhaler (Rx) NRT Options TRANSDERMAL NICOTINE PATCH Nicotine is well absorbed across the skin Delivery to systemic circulation avoids hepatic first-pass metabolism Plasma nicotine levels are lower and fluctuate less than with smoking DOSING Smoking history over 10 cigarettes per day: Usual dose follows a 10 week schedule: Weeks 1-6, use one 21 milligram patch per dayWeeks 7-8, use one 14 milligram patch per dayWeeks 9-10, use one 7 milligram patch per day Smoking history 10 or fewer cigarettes per day :Usual dose follows an 8 week schedule: Weeks 1-6, use one 14 milligram patch per dayWeeks 7-8, use one 7 milligram patch per day ADMINISTRATION Apply one new patch at the same time every day

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doi:10.1111/j.1360-0443.1932.tb04849.x