Comparison of interest	BNF recommendation	Review findings
Patch duration	“Individuals who smoke more than 10 cigarettes daily should apply a high‐strength patch daily for 6 ‐ 8 weeks, followed by the medium‐strength patch for 2 weeks and then the low‐strength patch for the final 2 weeks; individuals who smoke fewer than 10 cigarettes daily can usually start with the medium‐strength patch for 6 ‐ 8 weeks, followed by the low‐strength patch for 2 ‐ 4 weeks”   > 10 cigarettes per day: 10 to 12 weeks < 10 cigarettes per day: 8 to 12 weeks	Low‐certainty evidence of no effect of duration of nicotine patch use on smoking cessation.   Studies in the review typically recruited smokers who were smoking at least 15 cigarettes per day so comparisons with BNF guidance for individuals smoking < 10 cigarettes per day cannot be made.
Patch dose	“Individuals who smoke more than 10 cigarettes daily should apply a high‐strength patch… individuals who smoke fewer than 10 cigarettes daily can usually start with the medium‐strength patch…”   > 10 cigarettes per day: high strength (21/22/25 mg) then tapered < 10 cigarettes per day: medium strength (15 mg) then tapered	Moderate‐certainty evidence that 21 mg patches result in higher quit rates than 14 mg 24‐hour patches   Moderate‐certainty evidence that 25 mg patches result in higher quit rates than 15 mg (16‐hour) patches, though the CI includes one.   Moderate‐certainty evidence that 42/44 mg patches (not available in UK) are as effective as 21/22 mg patches   Low‐certainty evidence of no difference of dose on serious adverse events or treatment withdrawals   Studies in the review typically recruited smokers who were smoking at least 15 cigarettes per day so comparisons with BNF guidance for individuals smoking < 10 cigarettes per day cannot be made.
Patch tapering	“Individuals who smoke more than 10 cigarettes daily should apply a high‐strength patch daily for 6‐8 weeks, followed by the medium‐strength patch for 2 weeks and then the low‐strength patch for the final 2 weeks; individuals who smoke fewer than 10 cigarettes daily can usually start with the medium‐strength patch for 6‐8 weeks, followed by the low‐strength patch for 2‐4 weeks”   > 10 cigarettes per day: 6 to 8 weeks high strength, 2 weeks medium strength, 2 weeks low strength < 10 cigarettes per day: 6 to 8 weeks medium strength, 2 to 4 weeks low strength	No evidence of difference between tapering and abrupt patch cessation on abstinence   Studies in the review typically recruited smokers who were smoking at least 15 cigarettes per day so comparisons with BNF guidance for individuals smoking < 10 cigarettes per day cannot be made.
Patch 16‐hour versus 24‐hour	No reference to hours of use per day	No evidence of effect of hours of use per day on abstinence.
Ceasing versus continuing on lapse	“[If] abstinence is not achieved, or if withdrawal symptoms are experienced, the strength of the patch used should be maintained or increased until the patient is stabilised”   Continue on lapse	No evidence of effect on abstinence of instructing participants to continue using a patch versus stopping patch use, in the event of a smoking lapse.
Patch preloading	No specific reference but does refer to using patch prior to quit day to reduce cigarette consumption: “a slower titration schedule can be used [for patches] in individuals who are not ready to quit but want to reduce cigarette consumption before a quit attempt”	Moderate‐certainty evidence of a positive effect of NRT preloading on abstinence
Combination NRT	No reference to combination NRT	High‐certainty evidence that combination NRT results in higher long‐term quit rates, whether combination therapy was compared to patch or to a fast‐acting form of NRT. Low‐ to very low‐certainty evidence of no effect on cardiac adverse events, serious adverse events or study withdrawals
Type of NRT	No recommendations on which type of NRT to use.	High‐certainty evidence of no difference between fast‐acting NRT and patch on smoking cessation   Very low‐certainty evidence of no difference in effect of type of fast‐acting NRT (oral spray, gum or inhaler) on smoking cessation
Gum dose	“In individuals who smoke fewer than 20 cigarettes each day… 2 mg as required, chew 1 piece of gum when the urge to smoke occurs or to prevent cravings” “In individuals who smoke more than 20 cigarettes each day or who require more than 15 pieces of 2 mg strength gum each day… 4 mg as required, chew 1 piece of gum when the urge to smoke occurs or to prevent cravings, individuals should not exceed 15 pieces of 4 mg strength gum daily”   > 20 cigarette a day: 4 mg < 20 cigarette a day: 2 mg	Evidence that using 4 mg gum results in higher quit rates than 2 mg gum.   A post hoc subgroup analysis found a statistically significant benefit of 4 mg dose over 2 mg dose for higher‐dependency smokers, but not for lower‐dependency smokers.
Duration of gum	“Treatment should continue for 3 months before reducing the dose”	No significant effect of 50 weeks gum over 10 weeks gum use on smoking cessation
Fixed dose versus ad lib dosing for fast‐acting NRT	Gum: “Chew 1 piece of gum when the urge to smoke occurs or to prevent cravings” Sublingual tablet: “1 [or 2] tablet[s] every 1 hour” Inhalator: “As required, the cartridges can be used when the urge to smoke occurs or to prevent cravings” Lozenges: “1 lozenge every 1‐2 hours as required, one lozenge should be used when the urge to smoke occurs” Oromucosal spray: “1‐2 sprays as required, individuals can spray in the mouth when the urge to smoke occurs or to prevent cravings” Nasal spray: “1 spray as required, individuals can spray into each nostril when the urge to smoke occurs, up to twice every hour for 16 hours daily...maximum 64 sprays per day.”   Advice differs by type of fast‐acting NRT. Ad lib for gum and nasal spray	No evidence of an effect of fixed versus ad lib dosing of fast‐acting NRT (gum and nasal spray) on abstinence
As specified in the Methods section, we only carried out GRADE assessments and created summary of findings tables for some of the comparisons (and their associated outcomes) in this review. Therefore, only some of the review findings above are accompanied by a GRADE rating of the certainty of the evidence.   CI: confidence interval; NRT: nicotine replacement therapy