Additionally, NRT should be used with caution in smokers who:

• Have signficant underlying cardiovascular disease such as recent myocardial infarction, unstable or worsening angina including Prinzmetal's angina, recent stroke, or uncontrolled hypertension.
• Have severe renal or hepatic impairment
• Dermatological disorders such as psoriasis or dermatitis
• Nausea and vomiting
• Have hyperthyroidism
• Have diabetes (monitor blood glucose levels more often)

For women who are pregnant, smoking cessation should ideally be achieved without NRT. However, if the mother is unable to quit without pharmacological support, nicotine patches can be used as a safer alternative to smoking in pregnancy. Similarly, nicotine patches are safer than smoking in breastfeeding mothers. However, more intermittent forms of NRT such as the gum can help minimize the amount of nicotine in breast milk during feeding.

Nicotine patches are contraindicated in smokers who have hypersensitivity to nicotine or any component of the patch.