Accidentally smoking a cigarette while you’re wearing a nicotine patch won’t ruin your quitting plan, but it can increase your risk of nicotine poisoning.

If you’re ready to quit smoking, it’s understandable if you have a few questions.

Should you go cold turkey, or are there good replacement solutions, like gum or patches, to help ease nicotine cravings?

Does insurance cover smoking cessation products? How long will it take to quit smoking?

Many questions smokers ask center on cessation products, like nicotine patches. These products deliver measured doses of nicotine to help manage cravings and blunt your desire to smoke.

Knowing what to expect when using nicotine patches, as well as safety concerns about continuing to use tobacco while wearing one, can help you make a more realistic smoking cessation plan.

Let’s look at some of your most-asked questions.

The data is somewhat mixed about whether you can smoke while wearing a patch.

The Centers for Disease Control and Prevention (CDC) states that if you have one cigarette while wearing a patch, you can continue to wear the patch safely.

Meanwhile, patch manufacturers often state that their products are not designed to be used when smoking cigarettes. Combining a patch and a cigarette can increase the risk of nicotine poisoning.

A 2019 study found that for an adult to experience nicotine poisoning, they would need to consume anywhere from 1.8 milligrams (mg) to 100 mg of nicotine. It takes less than that for teens.

The CDC notes that 50–60 mg of nicotine is lethal for adults weighing roughly 150 pounds.

Some research has shown that a single cigarette can contain 10–12 mg of nicotine. But since much of it burns off, a person typically consumes 1.1–1.8 mg of nicotine from one cigarette, depending on the manufacturer.

So, while a single cigarette coupled with a patch might not be lethal, for someone who smokes a pack a day (roughly 20 cigarettes), it’s easy to reach nicotine levels that might cause side effects.

Heavy nicotine use can cause serious symptoms, such as:

More severe poisoning can lead to:

  • lowered blood pressure
  • lowered heart rate
  • fatigue
  • weakness

While rare in adults, extreme poisoning can cause:

How do nicotine patches work?

Nicotine patches are designed to deliver a steady amount of nicotine into your bloodstream through dermal transfer.

Depending on the dose, your patch might release 7–21 mg of nicotine throughout the day. Over the next several weeks, you begin to lower the dose.

The right dose for you depends on how much you smoked before quitting.

The CDC notes that people who smoked 10 or more cigarettes per day should use the highest strength, 21 mg.

It’s important to work with a doctor to determine the best dose for you. They can also monitor you and make sure the patch is working well for you and your quit plan.

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The CDC says you can begin to wear a patch immediately after your last cigarette. You don’t need to wait.

However, for best results, you can also take steps to avoid relapse, like throwing away any remaining cigarettes.

Patches can be one of the most effective ways to curb cravings and help you on your smoking cessation journey.

Some people benefit most by combining patches with other nicotine replacement products. If you’re a heavy smoker, combining patches with nicotine gum or lozenges can help you manage unexpected cravings.

If you have little success with patches, you can also ask a doctor about prescription medications, such as varenicline (Chantix) and bupropion (Zyban), to help you manage cravings.

Learn more about whether or not nicotine patches can help you quit smoking here.

Additionally, you may want to consider working with a quit coach, support group, or accountability partner to help you stay focused. Quitting smoking takes time. It’s not uncommon to have relapses.

If you want help quit smoking, several organizations, as well as state and federal programs, can provide information for support groups and resources to help you reach your goals, such as:

Looking for resources to help you quit smoking means you’re already making great strides for your overall health.

If you decide to use nicotine patches as a quit method, then it’s important to be armed with accurate information that can assist you in making an informed choice.

Nicotine patches can be an effective way to manage cravings and help you stay the course. Accidentally smoking a cigarette while wearing a patch won’t completely derail your cessation goals, but it shouldn’t become a habit. Consuming too much nicotine can increase your risk of nicotine poisoning.