Good for you for attacking the problem again. If patches work, then they work. If they don't, then you'll know it and think of something else. If you're in the medical field, you're smart enough to figure this out.
I was a serial quitter with gum, patches, tapering, and whatever else there is that is kind of quitting but not quitting. The imminent arrival of Covid to our shores is what got me to quit. It was having a reason strong enough. I believed that if I got Covid, after all the negative news I'd heard about fulminant lung infections, then I'd die. So I quit cold turkey, and a week later the first case of Covid was discovered in the USA, north of me about 20 miles. I took it as a sign to stay quit.
When a person finds their "WHY?" then they quit.
I'm struggling for quitting something else, and hearing myself as I write to you. I have some "WHY?" searching of my own to do.
Good luck to you. What you did once, you can do again, I'm sure of it. Keep us posted!