Nicotine replacement patches are subject to the 23% standard rate of VAT. It is not legally possible to apply the zero rate of VAT to nicotine patches. Under EU VAT law the zero rate of VAT can only be applied to those goods and services which applied at that rate on and since 1 January 1991. As nicotine patches did not apply at a zero rate in January 1991 it is not possible to apply the zero rate to them now.
However, the zero rate applies to oral medicines under this historical derogation. Nicotine inhalers, tablets and chewing gum qualify for the zero-rate of VAT on this basis.