For patients smoking more than 10 cigarettes per day, what is the initial dosing recommendation for the nicotine patch?

The recommended initial dosing for the nicotine patch for patients smoking more than 10 cigarettes per day is 21 mg/day for six weeks. This dosage is designed to provide sufficient nicotine replacement to help individuals manage withdrawal symptoms and cravings as they attempt to quit smoking. The 21 mg patch is aimed at those who have a higher level of dependence, which is evidenced by smoking more than 10 cigarettes daily.

The structured regimen typically begins with the higher dose patch for the initial six weeks to establish a good level of nicotine management. After this period, the dosage is generally decreased in a stepwise fashion to help minimize withdrawal symptoms while supporting the cessation process. The subsequent tapering phases may involve lower doses, but starting with the 21 mg patch is crucial for effectively addressing the nicotine cravings associated with heavier smoking habits.

This approach aligns with evidence-based guidelines for smoking cessation, which advocate for higher initial doses for patients with greater smoking dependence, ensuring they receive adequate support as they navigate the challenges of quitting.