Quitting with patches or gum, and what an app adds

Updated 6 September 2026

The short version

Nicotine replacement therapy, whether patches, gum, lozenges or spray, increases your chances of quitting. That is one of the most consistent findings in the field.
Combining it with behavioural support beats either alone. That is also well established.
NRT handles the chemistry: a controlled, falling dose. It does not remove the urge tied to your usual moments. Cravings still arrive, blunted, and something has to happen in them.
Not One More is the behavioural half. It is not nicotine replacement, does not replace it, and asks whether you use it so it never suggests otherwise.
If you are using patches or gum, keep using them. Use the app for the moment.

What nicotine replacement does

A patch gives you a steady, low dose of nicotine through the skin. Gum, lozenges and spray give you a faster, smaller dose when you want one. Either way, the point is the same: your brain gets some of what it is used to while you unlearn the habit, so the withdrawal, the irritability and fog and sleeplessness of days two and three, is blunted rather than faced at full strength. Over weeks, the dose comes down and the brain adjusts.

It works. The Cochrane review of nicotine replacement, covering well over a hundred trials, finds that it raises the chance of quitting by roughly half again compared with placebo or nothing, and that the different forms are broadly similar. Combining a patch with a faster-acting form is more effective than one form alone. This is settled enough that health services recommend it as a first choice.

What nicotine replacement does not do

It does not stop the craving that arrives at the top of every email, the end of every meal, the first coffee. Those are habit, not chemistry: the moment has been paired with nicotine hundreds or thousands of times, and a patch on your arm does not unpair it. People on NRT still get cravings. They are smaller, and they still need something to happen in them.

That something is the behavioural half, and the evidence for combining the two is as clear as the evidence for either. The Cochrane review of combined treatment finds that adding behavioural support to medication improves quit rates over medication alone, and that the two are complementary rather than redundant. One handles the chemistry. The other handles the moment.

What the moment needs

A craving lasts a few minutes. Two things are known to act on it within that window without medication: short, hard physical effort, which reduces cravings and lengthens the time to the next one, and slow exhaling, which lowers arousal in real time. Ten squats or thirty seconds of an isometric squeeze, then a few long breaths out, then wait.

Not One More is that sequence in about two minutes, with the reps counted by your phone and the craving curve on screen so you can watch it fall. It is a behavioural tool for one specific moment. It is not a medical treatment, it does not replace nicotine chemically, and it will not tell you to stop using something a pharmacist told you to use.

How the app treats NRT

During setup, the app asks whether you are using nicotine replacement. The reason is narrow and deliberate: so that nothing in the app, at any point, reads as a suggestion to stop. There are no dosing tips, no schedules, no “try without the patch today”. That is a pharmacist’s job, and the app is careful to stay out of it. Partly because it should, and partly because giving that advice is what would turn it into a medical device, which it is not.

What the app does do is treat a craving on NRT exactly like any other craving: something to get through, counted when you do. If you are stepping down your patch strength, the cravings-beaten count is the number that tells you how the step is going, because a day count says nothing about how hard the days were.

Questions

Can I use Not One More with patches?

Yes. It is built to sit alongside them. Keep the patch on, and use the app for the cravings that arrive anyway. The app never suggests changing what you are using.

Should I use gum or a lozenge during a craving instead of the exercise?

You can do both, and if a pharmacist has told you to use gum for cravings, do that. The exercise and the breathing act on the craving through a different route, so they add rather than compete. Many people find the effort gives them something to do in the minute before the gum takes effect.

Is vaping a form of nicotine replacement?

Not formally; e-cigarettes are not licensed as medicines. Some health services, including the NHS, do support switching from cigarettes to vaping as a route off tobacco. Not One More is for people who want off nicotine in whatever form, including vaping, and it does not take a position on how you got there.

Does the app work if I am not using any NRT at all?

Yes. Nicotine replacement is well evidenced and recommended, but plenty of people quit without it, and the craving looks the same either way. The app handles the moment regardless of what is or is not on your arm.

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, CD000146. NRT increases quit rates; forms are broadly similar; combining a patch with a faster-acting form is more effective. https://doi.org/10.1002/14651858.CD000146.pub5
Stead LF, Koilpillai P, Fanshawe TR, Lancaster T, Combined pharmacotherapy and behavioural interventions for smoking cessation, Cochrane Database of Systematic Reviews, 2016, CD008286. Behavioural support added to medication improves quit rates. https://doi.org/10.1002/14651858.CD008286.pub3
American Cancer Society, Nicotine replacement therapy to help you quit tobacco. https://www.cancer.org/cancer/risk-prevention/tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html
NHS Better Health, Quit smoking. https://www.nhs.uk/better-health/quit-smoking/
NHS, Using e-cigarettes to stop smoking. https://www.nhs.uk/live-well/quit-smoking/using-e-cigarettes-to-stop-smoking/
Ussher MH et al., Exercise interventions for smoking cessation, Cochrane Database of Systematic Reviews, 2019. https://doi.org/10.1002/14651858.CD002295.pub6
Balban MY et al., Brief structured respiration practices enhance mood and reduce physiological arousal, Cell Reports Medicine, 2023. https://doi.org/10.1016/j.xcrm.2022.100895

Get through the next two minutes

Then do it again the next time. That is the whole method.