The objective of this study was to test the efficacy of the nicotine patch for relief of craving and withdrawal beyond 6 weeks (during weeks 7-10), among heavy, dependent smokers, using a multicenter, randomized, double-blind, placebo-controlled trial. The subjects were 421 nicotine-dependent smokers who had quit smoking with the NicoDerm CQ nicotine patch, recruited from among enrollees in the NicoDerm CQ Committed Quitters behavioral program. Following 6 weeks of 21-mg active patch use, participants who had not relapsed were randomized to receive either active or placebo patches for an additional 4 weeks with tapering (14-mg patch in weeks 7-8 and 7-mg patch in weeks 9-10). Craving and withdrawal symptoms were assessed daily by phone interview during weeks 7-10 following cessation. The active patch group reported significantly lower craving and withdrawal, and higher positive mood scores in weeks 7-8 (p < 0.001, 0.001, and 0.03, respectively) and weeks 9-10 (p < 0.02, 0.01, and 0.02, respectively) compared to the placebo group. It was concluded that some smokers may be best served by 10 weeks of patch treatment. This study demonstrated the utility of continuing patch treatment for symptom relief in weeks 7-10 of abstinence. Future research should examine the optimal duration of treatment, which may vary across different classes of smokers.