Quit aids
Patches, gum or lozenges: which quit aid works
Every form of nicotine replacement raises your odds by about half. Using two together raises them again.
Written by Lee H. Last reviewed 18 October 2026.
The short answer
Nicotine replacement therapy (NRT) gives you nicotine without the smoke, so the withdrawal is smaller while you break the habit. The largest review of the evidence, a Cochrane review of 133 trials, found that every form studied (patch, gum, lozenge, inhaler, nasal spray) raised the chance of staying quit for six months or more by about 50 to 60 percent, compared with placebo or nothing.
Which form matters less than people expect. What matters more is using enough, for long enough, and pairing a patch with a fast-acting form.
The three you can buy over the counter
- The patch. A steady dose through the skin all day. Nothing to remember after you put it on, and nothing to reach for when a craving hits.
- Gum. Fast-acting. Chew until it tingles, then park it against your cheek, and repeat. Chewing it like ordinary gum releases the nicotine too quickly and can upset your stomach.
- Lozenges. Fast-acting, dissolved slowly in the mouth. Nothing to chew, which suits people with dental work.
In the US the inhaler and the nasal spray need a prescription.
Patch or gum: the head-to-head
The 2019 Cochrane review compared the patch directly with the fast-acting forms and found no clear difference between them. So the honest way to choose is by how you smoke:
- If you smoke steadily through the day, the patch matches that pattern.
- If your smoking comes in bursts (coffee, the drive home, after meals), a fast-acting form answers the moment.
- If you want the best odds, do not choose. Use both.
Why two beat one
The same review found that combination NRT, a patch for the background level plus gum or a lozenge for cravings, raised quit rates by about a quarter over a single form. The patch takes the floor out from under withdrawal; the fast-acting form handles the spikes the patch is too slow for.
The review also found that starting the patch a short while before your quit day, rather than on the day, may help. A pharmacist can tell you which strengths fit how much you smoke.
Counting what you use
The Long View is my app, and this is where it fits, stated as disclosure. You can turn on patches, gum and lozenges in Settings and count them on Today next to cigarettes, so you can watch the aids taper as the weeks go by. It counts them without a money figure. You can run the life-years math without installing anything on the quit smoking calculator.
Common questions
Which works better, the patch or the gum?
Head to head, the Cochrane review found no clear difference between the patch and the fast-acting forms (gum, lozenge, inhaler, spray). Pick the one you will actually use as directed.
Can you use a patch and gum together?
Yes, and it works better than either alone. The 2019 Cochrane review found combination NRT, a patch plus a fast-acting form, raised quit rates by about a quarter over a single form. Ask a pharmacist or doctor about doses.
Does nicotine replacement actually help people quit?
Yes. Across 133 trials, the 2018 Cochrane review found every form of NRT raised the chance of quitting for six months or more by about 50 to 60 percent compared with placebo or no NRT.
Sources
- Hartmann-Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. "Nicotine replacement therapy versus control for smoking cessation." Cochrane Database of Systematic Reviews, 2018. doi.org/10.1002/14651858.CD000146.pub5
- Lindson N, Chepkin SC, Ye W, Fanshawe TR, Bullen C, Hartmann-Boyce J. "Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation." Cochrane Database of Systematic Reviews, 2019. doi.org/10.1002/14651858.CD013308
Nothing on this page diagnoses, treats or prevents any condition, and none of it is medical advice. Read the label, and talk to a doctor or pharmacist before using NRT if you are pregnant, have heart disease, or take other medicines. Talk to a doctor or a quitline about stopping. In the US, that is 1-800-QUIT-NOW.
Keep reading
Where to go next
Cold turkey or gradual?
What the trials found about the two ways in.
What happens when you quit
The recovery timeline, hour by hour to year by year.
After a slip
What a lapse costs, and what it does not.