If you can stick it, you can kick it: A nicotine patch? I'll never be able to swallow it, said Susannah Frankel. Four months on, she's a non-smoker

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The nicotine patch is like a big, round, yellow plaster. The first time I saw one was at the doctor's. I was there because a nasty cold had turned into a cough and then into a chest infection.

'You really ought to think about giving up smoking,' he said.

I was shocked. Didn't he realise that thinking about giving up, talking about giving up, wondering when, how and where to give up is the smoker's constant condition? I'd tried everything from expensive counselling courses to nicotine gum. But I was a committed smoker. None of that I-only- smoke-in-the-evenings stuff for me. I was the sort of smoker who wakes up in the middle of the night for a top-up. I'd even perfected the art of smoking while exercising - healthy smoking.

'But I love smoking,' I pleaded. 'What about if I give up dairy products instead?'

The doctor's eyes glazed over.

'Well, I hope you don't expect me to swallow that great big thing,' I snapped irritably.

The doctor pointed out that I was supposed to stick the nicotine patch on to my skin, and that it would release a constant amount of nicotine into my bloodstream. The idea, he said, was that the patch would deal with the (physical) addiction to nicotine while I coped with giving up the (psychological) habit.

'Does it hurt?' I asked.

'No,' he said.

'Can I have some nicotine gum as well?' (This could be great.)

'No,' said my doctor. 'And don't smoke with the patch on either. You'll have a nicotine overdose - headaches, dizziness, nausea, that sort of thing.'

Later, at the chemist, I was in for a shock. The patch is not available on the NHS. You can buy it over the counter at most chemists and with a prescription you will save 17.5 per cent VAT. Even so, at a little more than pounds 160 with a prescription and up to about pounds 180 without one, for a 12-week course, it's not exactly a bargain. I bit my lip. As I was smoking up to 30 cigarettes a day, which was costing around pounds 90 a month anyway, perhaps it wasn't unreasonable.

There are two types of nicotine patch available: a 24-hour one (Nicotinell and Nicabate) and a 16-hour one (Nicorette). The difference in cost per week between the three is negligible.

Manufacturers of the Nicorette patch believe, quite reasonably, that most people aren't like me and don't smoke through the night and that it's therefore sensible to take the patch off before going to bed. Manufacturers of the 24-hour patch, which I had been prescribed, claim, equally convincingly, that having the patch on during the night makes you less likely to crave a cigarette when you wake up - heavy smokers usually light up within half an hour of waking.

Not surprisingly, they don't point out that going to bed with a gigantic plaster stuck on one or another part of your anatomy (you are advised to stick the patch in a different place every day to avoid skin irritation) isn't exactly erotic. But then neither is smoking.

Patches come in weekly or four- weekly supplies. For the first four weeks you use one large patch a day, for the second four weeks (sadly) a smaller one, and for the third four weeks a smaller one still. Your body gradually gets used to lower and lower levels of nicotine. By the time you've finished the course, you're over the worst of it and well on the way to success. At least that's the theory.

My Nicotinell 24-hour patches came with a 'Patient Support Book' explaining how the patch works and offering tips on how to make giving up easier. 'Change your routine,' stated my Support Book. 'If you always smoke first thing in the morning, try getting up a few minutes earlier and doing a few exercises by an open window instead.' Were they stark raving mad? As if giving up smoking weren't traumatic enough.

There was also an 'Emergency Card' on which I had to write down three main reasons why I had stopped smoking ('mortality fears', 'expense', 'my doctor made me') and four things I could do to take away the craving for a cigarette ('eat - not sweets', 'drink - not alcohol', 'make something - not a cake', 'brush your teeth'. This last one definitely works.) I had to look at this card, my Support Book said, when I felt tempted to relapse.

Finally, I had my Nicotinell calendar - a masterpiece of psychological manipulation - a poster of the inside of a block of flats and lots of stickers of tiny (non-smoking) cartoon men and women, one of which I had to stick on the poster every day I didn't smoke, each in its own special place.

The first week of giving up was a breeze - my Evangelical Period. I felt great and any cravings were overshadowed by how proud I was not to need to smoke. Bitter smokers were quick to remind me that newborn non-smokers were always full of the joys of a smokeless existence but that I would soon start smoking again. But I wouldn't hear of it. Even at the most testing times - after dinner in a restaurant, in a pub, at a party - my resolve was unshakable.

People would offer me cigarettes. 'Why don't you have one of mine,' I'd say, thrusting my pack of patches towards them.

I thought about how my hair, clothes and flat must have smelt before and how climbing the stairs to my flat used to push me to the point of collapse. I thought of the evenings wasted hanging out of non-smoking friends' windows, on their balconies and doorsteps. I noticed that I felt brighter in the morning, that my skin looked clearer. I was delighted to have given up smoking.

Perhaps inevitably, things didn't stay that easy for long.

Over the next few weeks I often felt anxious and irritable. I couldn't concentrate, didn't know what to do with myself, I felt disillusioned. It wasn't until I forgot to change my patch one day that I realised that I could have been feeling a lot worse. 'Are you sure you put on a new patch this morning?' asked my boyfriend as my breakfast plate whistled past his right ear.

Also, as I was still taking in nicotine, my metabolism wasn't slowing down suddenly and I wasn't putting on inordinate amounts of weight - supposedly one of the main causes cited by smokers, female smokers in particular, of starting up again.

Six weeks passed without a single relapse. Well, there was just the one. After dinner one night, I happened to be sitting next to a cigar smoker. Fantastic, I thought. As long as it wasn't a cigarette. I immediately grabbed one of his cigars and, while eagerly extolling the virtues of not smoking, smoked the lot in five minutes, gulping down the smoke while other guests looked on in disbelief. When I got home, apart from feeling distinctly queasy, I was not allowed to put a cartoon man up on my calendar.

After about seven weeks, I'd become blase about putting a new patch on each day. I'd go without one for two days, sometimes three or four, and felt fine. After 10 weeks, I stopped using them.

The news isn't all that good, however. Although a recent Gallup survey of 1,000 smokers showed that after 12 weeks 41 per cent of smokers given the Nicorette patch gave up, compared with only 10 per cent given a placebo, trials in the United States, where the patch has been around since the end of 1991, found that success rates fell to 17 per cent in nicotine- patch users and 4 per cent in dummy patch users after a year.

With sales already in excess of dollars 1bn and around 17 million Americans a year attempting to give up smoking (90 per cent unsuccessfully), the financial success of the patch is less debatable.

Personally, it's now four months since I smoked a cigarette and I've never felt better. It was great to make room for some other new year's resolutions this year.

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