The success of nicotine replacement therapy (NRT) in smoking cessation is affected by the patient's understanding of how to get maximum benefit from the device, hence the importance of counselling. But there are some things that even the most seasoned counsellors may omit to mention, on the grounds that it is fair to assume the user already understands them. Staff at a smoking cessation clinic in London, UK, recently encountered a patient who was trying to stop smoking with the help of a nicotine patch, but reported feeling no benefit from it. Further gentle counselling was called for when it turned out why. She had been wearing the patch on the sleeve of her coat.