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The nicotine patch will be dispensed weekly during this titration phase, with dose adjustments made by the study physician at each weekly study visit based on tolerability and the average number of cigarettes smoked per day (CPD) in the preceding week (see Table 1 for the dosing algorithm based on amount of continued smoking)

Management differs because you will treat vaginal atrophy with topical estrogen and lubrication, but vaginal leukoplakia often requires removal of irritants, topical or systemic agents guided by biopsy, and sometimes surgical excision for refractory lesions

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This leads to reinforcement, cravings, and withdrawal symptoms when levels drop

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