Nicotine (Patch) Dreams: The Weirdest Side Effect of Quitting Smoking

You're going to have intense dreams if you use a nicotine patch. Does the upside outweigh the downside? Illustration by me.

I started smoking while still in high school when I was about 15, and unlike a lot of people, I never once tried to quit. I barely ever even considered it the entire time. But three things occurred in short order: my mom (who quit smoking several years ago) was diagnosed with COPD, and I found myself battling a case of bronchitis for the past few months that left me wheezing and gasping for air each night. The third thing was that my 50th birthday is quickly approaching, and if I was ever going to quit, all the writing on the wall said that this was the time.

I started in early March by halving the amount of cigarettes I smoked -- from a pack of 20 per day to about 10 -- simply by being more aware and conscious of my need for smoking. Each time I'd get up to have a smoke, I'd just ask myself if I really, really needed it. If the answer was no, I'd sit back down and distract myself for awhile until the momentary urge passed. This worked up to a point, but there's a name for someone who smokes 10 cigarettes a day... and that name is "a smoker". I wasn't making any more progress on my own, so when I finally saw my doctor to treat the bronchitis last Friday, I also told her about my smoking cessation efforts. I was happy to find that she was pleased with my efforts I'd made thus far (we smokers are more accustomed to being yelled at and guilt-tripped when talking to doctors about smoking), and she understood that the next steps would require a little help. Therefore, she prescribed a transdermal nicotine patch. Since I'd already brought down my smoking level by half, she started me at a "step 2" patch, which provides 14mg of nicotine through skin absorption.

These things have been part of my life since I was 15. They used to be called "Marlboro Lights" until a legal case made it clear that no type of cigarette is less dangerous than any other in terms of the likelihood of smokers developing a variety of deadly ailments as a result of smoking. By the way, they're now about $10/pack (up from under a dollar a pack when I was a kid), so this carton is around $100. Also, smoking is less socially acceptable among all age groups than ever before. So other than being expensive and making you unpopular, they'll kill you, all of which adds up to a pretty good reason to try and quit.

The way it works is pretty simple. It looks like a square or circular Band-Aid, with a plastic top and an adhesive backing (there are clear ones available, for people who feel better about that, I suppose). You pick an area with less hair like an upper arm, then put the patch on in the morning and leave it there for 24 hours. The way it works is fairly obvious; by giving your body a small but steady flow of nicotine throughout the day, it reduces the symptoms of physical nicotine addiction so that your desire to smoke is lessened. Eventually, you move to "step 3", which is only 7mg (less than the amount in one typical cigarette), and then if things go as planned, you leave nicotine and smoking behind forever.

Does the patch work? It certainly has for some people. I'm only a couple of days in, but I can already tell you that while wearing it, my ability to go longer and longer in between smokes is increasing... a good sign. I can also tell you that it does not completely remove the desire to smoke, much of which is based on habit rather than the actual addiction. I'm going to continue to slowly pare down my smoking rate; yesterday was a new record for me, with only seven cigarettes between waking at 6am and heading to bed at 11pm. I haven't noticed any side effects from the patch -- no skin irritation, no nausea -- except for one that I was told about beforehand but had to experience to really understand: nicotine patches give you incredibly intense dreams.

The patches themselves are pretty basic, and are available over the counter (no prescription required). You slap one on yourself in the morning, and leave it there until you slap another one on the next morning.

Why do Nicotine Patches Affect Your Dreams?
Dreams are pretty bizarre in and of themselves, and there are a number of theories as to what dreams are and how/why we experience them. We certainly know that dreaming seems to be essential to the health of all mammals. There are many theories as to the physiological and psychological origin of dreams.

A typical smoker does not ingest nicotine while sleeping for obvious reasons... you don't smoke while you sleep, or at least I hope you don't. But nicotine patches are designed to meter out the nicotine dose steadily over a 24-hour period, meaning you're getting just as much while you sleep as when you're awake, ostensibly to control the urge to smoke first thing in the morning (which, by the way, is still a goal I have yet to achieve). And therein lies this crazy side effect to wearing a nicotine patch all night: intense, vivid dreams. The scientific theory is that nicotine suppresses a type of brainwave that usually happen right before you go into REM (rapid eye movement), the stage at which you have dreams. The result is that you have a level of brain awareness that is more in line with what you experience while awake, and therein lies the problem.

What I've found is that the dreams are indeed intense. Are they always nightmares? Not specifically so, but the intensity of the imagery and basic plot lines made them feel nightmarish at the time. One big difference is that instead of the "walking through jello" aspect of slowness that often accompanies my dreams, there was none of that on the nicotine patch... things seemed much more in line from an aspect of time perception as it would in waking life, adding to the strangeness. Also, I've awakened several times each night after these dreams -- not something I usually do, as a really good sleeper -- and it took a little while each time to drift off again. I felt more alert during these moments of wakefulness than I usually would while coming out of a deep sleep in the middle of the night (though again, I was back asleep with no problems a few minutes later).

Memories... Light the Corners of my Mind
I'm a person who tends to remember his dreams... not in detail, but well enough to have some specific images in my head on most mornings when I awaken (which often fade quickly as the day progresses). One thing about nicotine patch dreams is that they seem much more memorable the next morning, in high detail. I will also state that I had that sensation of having "dreamed all night". It's not necessarily a good thing, and to a small degree, I feel slightly less well rested than I usually do.

Another note: some people have claimed that they've experienced lucid dreaming while sleeping with a nicotine patch. A lucid dream is one where you are aware that you're dreaming and can exert some degree of control in your dream state, be it by flying, transporting yourself into various places and situations, and so on. It's been super rare for me to experience this, and is usually very fleeting; even if I become aware that I'm dreaming, something happens in the dream and I lose that awareness and go back to viewing whatever my brain shows me. I have not had a lucid dream yet on the nicotine patch, but it's only been a couple of nights, so perhaps I have that to look forward to... sort of.

Is It Worth It?
Look, I'm not here to tell you what's good or bad for you, or what you need to prioritize. It would be insanely hypocritical for me, after 35 years as a steady smoker, to start proselytizing about how good it is to be a non-smoker -- even more so, since as of yet, I'm still a smoker. It will likely be months before I fully quit, assuming I'll be successful at this effort. But in that regard, while I was able to get down to 10-11 cigarettes a day on my own, the last couple of days on the patch, I've smoked less than any time before now, and I feel more confident that I can continue to reduce my smoking and eventually stop. That was literally unimaginable to me previously.

I'm happy with the way my smoking reduction and cessation efforts have gone so far. I have a ways to go, but with the patch and a newfound sense of optimism and confidence, I think I'm going to be successful at this... and I can deal with some weird dreams. After all, I'm a weird guy.

To me, a dream is simply what it is; a series of images and sensations that are not real. As an adult human being, I'm going to assume that you are capable of having dreams and not allowing them to entirely freak you out or ruin your life. I will likely get used to these new sensations that occur while I sleep with a nicotine patch on. At some point, perhaps in the next four to six months, I won't require the patch or the cigarettes. At that point, my quality of life will improve, and my chances of living to a reasonably old age increases by many times. While I enjoy smoking, I also enjoy living, and it's with that thought in mind that I consider this effort fully worthwhile, with weird dreams and all.