Do they though? I've wondered this before as a non-smoker.

I assume patches are slow release but smoking provides a bigger hit all at once. Sometimes that's important, both in terms of impact and building tolerance.

Nicotine without smoke is still not a great thing to consume and has it's own negative effects such are arterial hardening leading to increased heart attacks and strokes. While it is far better than smoking, it still known to cause long term health problems. Getting the stimulating effects of nicotine also takes fairly sensitive portion control. Too little and it is not going to stimulate, too much and you will want to barf for the next 45+ minutes.

Psychology of habit plays into this.

The downside of patches is the slow release. Smoking is instantaneous.

uhhh i don't know if you've noticed, but Juuls sure seem pretty popular right now...