smoking & nicotine patches

[nerakrose]

hello!

I have a character (scandi noir detective) who's a heavy smoker considering maybe quitting smoking because he's discovered the person he's into is using nicotine patches and he's like, wait, should I...stop smoking?? he is aware that he smokes too much but he's also a Mess with Issues so he's never thought about quitting smoking before.

he's some flavour of neurodivergent and has sensory issues with clothes, so he wears the same type of clothes every day (a suit and tie). he is also potentially allergic to the adhesive in generic plasters - I've not decided on this yet - could this be an issue with nicotine patches?

he smokes primarily when he's frustrated (which is often) and when he needs to think (ditto) or as an excuse to get away from an uncomfortable social situation. I don't know how nicotine patches work aside from the fact I think you're supposed to wear 1 patch for several hours? and this guy probably would not bother reading what the box says, he'd just buy a box and slap on a patch and go on about his day, so I'm also envisioning him slapping on a new patch anytime he wants to light a cigarette, potentially ending up with like 6+ patches on his forearm over the course of a day.

what would be the potential consequences of this? is that even realistic? is there anything I haven't thought of?

eta to clarify: I'm looking for pointers on how to torture this already tortured blorbo rather than a feasible way to give up smoking :D

thanks!!

Comments

[tiggymalvern]

I have no personal experience with nicotine patches, but any patch can commonly cause at least low level skin irritation. The advice is always to apply new patches on different areas of skin to try and minimise it. Here's the CDC info on nicotine patches, how to use, side effects etc.

https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/quit-smoking-medications/how-to-use-quit-smoking-medicines/how-to-use-a-nicotine-patch.html#tabs-1-2

Common side effects of nicotine patches:

https://www.medicalnewstoday.com/articles/nicotine-patch-side-effects

Symptoms of nicotine poisoning, including what would be a fatal dose:

https://my.clevelandclinic.org/health/diseases/21582-nicotine-poisoning

[nerakrose]

I did not know nicotine poisoning was a thing, oh my god. (Though now I wonder if I should poison my guy for the extra ✨drama✨!) Thank you so much!

[akacat]

It probably has no practical purpose for you, but there’s an episode of X-Files that deals with nicotine poisoning. I can look up the episode name/number for you, if you’re curious.

[michelel72]

Criminal Minds, too: Heathridge Manor (719).

[conuly]

Isn't nicotine used as a rat poison?

[nerakrose]

I would not know that, I’ve never had to poison a rat :')

[voidampersand]

https://www.nhs.uk/better-health/quit-smoking/vaping-to-quit-smoking/#:~:text=Switching%20to%20vaping%20significantly%20reduces,vaping%20is%20not%20risk%2Dfree.

[shinsengumi]

Not the OP, but thanks for this link. I've sent it along to my diabetic, has-had-two-heart-attacks-and-still-smokes relative for the hopes of them improving their health.

[full_metal_ox]

Between the smoking and the diabetes, how many body parts have they lost so far?

[nerakrose]

thank you! I've ruled out vaping because this guy would probably rather die than use one of those, and I'm not looking for feasibly ways for him to quit smoking, rather I'm looking for ways to torture him a bit. ;)

[autodach]

Applying multiple nicotine patches at once can potentially be harmful.
This paper for example concludes that "Nicotine poisoning resulting from transdermal exposure is a rare but potentially serious condition": https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10222450/

[nerakrose]

thank you! I wasn't aware of nicotine poisoning before but I'm now thinking of adding that as a plot point, so this is very helpful.

[olivermoss]

What era is this? Would nicotine gum be a possibility? It's more active and no skin issues, but like with any replacement it's always possible that the person gets more addicted, like how vaping has lead to some teens already at super high levels of addiction.

[nerakrose]

Circa 2019!

I’ve ruled out gum because it’s not very in character for this guy - and the point is kind of to torture him a bit rather than feasibly have him give up smoking. *slaps the back of this blorbo* I can fit so many issues in this guy

[olivermoss]

Gotcha, happy torturing!

[michelel72]

Trust anyone with experience over my half-remembered references, but a few factors you can consider:

- Smoking alters the uptake of mental health medications (possibly others, but those were the focus of an article I once read) -- so if he's on any, they might work better or worse if he's changing his habits. I don't recall if the effect was specifically due to nicotine or to any other chemicals delivered by smoking.

- Smoking can be a very, very physical act, and it sounds like that might be relevant for your character. Many people have trouble quitting actual-smoking because smoking gives them things to do with their hands and mouth, and it gives them rituals for socialization and/or self-soothing. The nicotine is almost certainly relevant, but it's also almost certainly not the only part of smoking your character "benefited" from. It would not be at all atypical for your character to need to fidget with a pen, ruler, comb, or whatever folks in that part of the world use as celery/carrot/pocky-type snacks. He might even find himself miming "smoking" them. (There's a degree to which the brain will be trained to think "I light this thing on fire and hold it like this, and soon I feel better", such that acting out the sequence feels like it works but slapping on a patch -- or, real-world ideally, remembering you're wearing a patch -- feels ineffective.)

[reynardo]

I still hold my right hand as if the index and middle finger have a cigarette between them.

It's been 33 years, 8 months, 30 days and 22 hours since I gave up - but who's counting?

[full_metal_ox]

Congratulations! I realize it’s a lifelong struggle; my dad walked in those shoes (and good for him: the notches on Johnny Smoke’s gun barrel included my maternal grandparents.)

[reynardo]

the notches on Johnny Smoke’s gun barrel included my maternal grandparents. And my paternal grandfather too.

Thank you. It's weird - I know it would make me ill, send my asthma over the top, and be the one thing to make my husband reconsider our marriage, and yet occasionally the thought does still cross my mind.

Damn those drugs.

[nerakrose]

Congrats! My mum and dad tied to quit smoking together about 32 years ago (I remember because I was with them at the appointment with the specialist they were seeing), but while my mum was able to quit, my dad wasn’t.

[reynardo]

It's not easy. My mum only managed to quit by going on a holiday where it was 8km to the nearest shop and she'd have to walk. Me, it was the standard 26 day Outward Bound course - 26 days of no smoking, no drinking, no non-prescribed drugs, out in the wilderness. I never want to do that again.

[full_metal_ox]

It would not be at all atypical for your character to need to fidget with a pen, ruler, comb, or whatever folks in that part of the world use as celery/carrot/pocky-type snacks.

May I suggest salmiak, that intense salty medicinal-tasting black licorice popular in Nordic and Scandinavian regions? It’s available in a wide variety of shapes, including tubes and bars that might lend themselves to cigarette reflexes.

[nerakrose]

If he winds up eating several sticks of liquorice a day he’s going to poop black and potentially have blood pressure problems :'D although you have a point and läkerol or gajol liquorice pastilles might be useful

[full_metal_ox]

Speaking of pooping: don’t forget nicotine-withdrawal-related constipation.

[nerakrose]

Ah! I did not have that on my list. *takes notes*

[nerakrose]

Thank you! And yes, good point - I can definitely see him wind up chewing on pens a lot or snacking more to compensate for that part of it.

(He’s not currently on mental health medication but that doesn’t mean I can’t put him back on them 👀)

[lilacsigil]

If he's actually Scandinavian rather than just Scandi-noir flavoured, have you looked into snus?

Adhesive sensitivity is very common, and can be affected by other issues too - so if it's a bad pollen day, he may get more itchy and more of a rash. The generic plasters are usually beige, the brand ones clear, and there is a difference in the adhesive according to many patch-users I have spoken to. There are lots of options other than patches, but men seem to want patches or gum or (less often) lozenges, not the sprays or vapes. You're supposed to wear one patch for 16 or 24 hours, depending on the brand.

The immediate side-effects of too much nicotine are dizziness and nausea. A very common side-effect is extremely vivid dreams.

source: work in pharmacy, trained in nicotine replacement therapy

[nerakrose]

He is, he’s Danish (as am I :) ). I hadn’t thought of snus at all, actually, I don’t think that occurred to me as something he’d even like. My impression of it is that demographically it’s old men OR young people using it - this guy is 45 in 2019. His dad probably uses it, and his stepson’s/stepson’s friends.

Thanks!! That’s all very useful information

[full_metal_ox]

Out of curiosity, are we talking Rolf Larsen from DNA?

[nerakrose]

I don't know who that is unfortunately! this is about Carl Mørck from the first four Afdeling Q movies (I've not seen the others). Also not the books.

hope this helps

[(Anonymous)]

unfortunately i never used patches BUT i did accidentally quit smoking when getting on antidepresaants.
so far Doxepin does the same (its a sleeping pill that I was prescribed that's nonhabit forming)
Fluoxetine/ prozac can do it. sertraline (zoloft?) does it which I'm on right now. sorry for rambling basically you can make your character even accidentally quit smoking while using any meds with smoke cessation

Re: hope this helps

[nerakrose]

thank you! that's super useful to know, I had no idea antidepressants could have this effect. I was on sertraline for about a year one time and noticed nothing of the sort, but then again I wasn't smoking xD

[(Anonymous)]

hey, i quit smoking a year ago with the help of patches! other commenters are spot on about multiple patches & nicotine poisoning, but i did want to add another warning on the box that your guy may not read: wearing one while you sleep can cause pretty intense/vivid dreams. i always removed mine before bed for this reason. also, they’re kind of itchy for the first 10-15 min you put one on, but it passes pretty quickly. good luck with your story!

[nerakrose]

thank you!

[clavally]

I quit smoking with the patch. There are warnings on the box not to smoke a cigarette within an hour of removing the patch for fear of nicotine poisoning. It's oddly how I quit-I knew I wouldn't be able to smoke for an hour if I took the patch off anyway, so I just never took it off. You're supposed to wear one a day, change the site of the patch to keep from skin irritation, and it's a step-down process where you get patches for a specific phase of quitting and as you do the program, the level of nicotine in the patches decreases.

I can also tell you I was an absolute nightmare to be around for the first 3 months. I was angry, short-tempered, etc, and took it out on everyone around me. I had to make lots of apologies when it was over with.

[nerakrose]

thank you! that's so helpful. also I'm sorry it was so hard for you, I hope everything turned out OK with no permament damage to relationships.

[(Anonymous)]

If he's allergic to band aids/plasters, he may also be allergic to the patches. I broke out in hives when I used the patch, similarly to how I am when I use a regular band aid. Had it on, took a shower, in hindsight it was funny but my back was a scary sight for a day. I have an autoimmune disorder to blame, but I'm sure there are other reasons one might be allergic to the adhesive.

[nerakrose]

thank you! and oof, that sounds awful.

[ceciseesaw]

that would be FAR too many patches. a nicotine patch isnt equitable to one cigarette so much as a pack of them (20 cigarettes).
Its also worth noting that part of the addiction that comes with smoking is not just to the nicotine, but to the ritual. Opening a new pack and flipping a lucky, lighting the cig, flicking off the ash, stubbing it out, etc, these are all things that are just as -- if not more -- important to me as the actual nicotine. If your character is trying to cut down on smoking, they are likely going to have other fidgets/habits aside from general nicotine craving, etc, they may absentmindedly flick their lighter, set fire to small twigs, put pens and other things in their mouth like a cig, hold and flick their pens similar to a cig, flick at their fingers, etc. There are for sure more but these are just ones that I/other smokers in my life tend to do both in general as well as when we're cutting down on how much we smoke.
So something you can do to show that he's craving a cigarette (that isnt having him give himself nicotine poisoning lol) is show him doing some of these behaviours and tics

[nerakrose]

thank you, that's helpful to know! i'm definitely thinking of ways to get ritual/fidgety bits through and what he'd do.