Combining the nicotine patch with an ad libitum type of NRT increases success rates.

Using two different forms of NRT could increase quit success by producing higher blood nicotine levels, however, the increment in success produced by combination NRTs is probably due to the use of two distinct delivery systems: one passive and one ad libitum. Use of the patch to establish a background level of nicotine, combined with using gum, inhaler/inhalator or nasal spray when cravings occur, may provide better control of withdrawal. There is no evidence that using more than one form is likely to lead to nicotine overdose (see Safety section).

Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2008; 1.

Report of the Committee on Safety of Medicines Working Group on Nicotine Replacement Therapy. Medicine and Healthcare products Regulatory Agency Committee on Safety of Medicines, 2005.