From the Guidelines
Neither buccal nicotine nor ingested kratom can be considered "healthy" options, as both substances carry significant health risks. Buccal nicotine (absorbed through the cheek or gum tissue) delivers nicotine, which is highly addictive and associated with cardiovascular problems including increased heart rate, blood pressure, and risk of heart disease, as noted in studies on smoking cessation 1. Kratom, an herbal substance derived from a Southeast Asian tree, contains compounds that can act on opioid receptors and may cause dependence, withdrawal symptoms, liver damage, seizures, and has been linked to numerous deaths. While nicotine delivery methods that avoid combustion (like buccal products) eliminate the carcinogenic risks of smoking, nicotine itself remains harmful, with evidence suggesting that nicotine replacement therapy (NRT) can help smokers stop, but it does not provide a complete replacement for cigarettes, nor replace the need for willpower 1. The most recent guidelines on smoking cessation support the use of combination NRT, which offers the greatest potential benefits for smokers, with a Cochrane network meta-analysis showing that combination NRT is superior to single forms of NRT 1. However, in the context of comparing buccal nicotine to ingested kratom, it is crucial to prioritize the substance with the least harmful effects and the most regulated and evidence-based use, which would be buccal nicotine as part of a smoking cessation program under medical supervision. If you're using either substance to manage pain, stress, or addiction, consulting with a healthcare provider about evidence-based alternatives would be significantly safer than continuing use of either substance. Key points to consider include:
- The addictive nature of nicotine and its cardiovascular risks
- The unregulated and potentially contaminated nature of kratom products
- The importance of evidence-based smoking cessation programs that may include NRT
- The need for medical supervision when using any substance for cessation or management of addiction and pain.
From the FDA Drug Label
Warnings If you are pregnant or breast-feeding, only use this medicine on the advice of your health care provider. However, the risks to your child from this medicine are not fully known. Ask a doctor before use if you have heart disease, recent heart attack, or irregular heartbeat. Nicotine can increase your heart rate high blood pressure not controlled with medication. Nicotine can increase your blood pressure.
- Buccal nicotine has known risks, including increased heart rate and blood pressure.
- There is no information about ingested kratom in the provided drug label. The FDA drug label does not answer the question.
From the Research
Comparison of Buccal Nicotine and Ingested Kratom
- There is no direct comparison between buccal nicotine and ingested kratom in the provided studies.
- However, the studies discuss the effectiveness of nicotine replacement therapy (NRT) for smoking cessation 2, 3, 4.
- Buccal nicotine is mentioned as a novel delivery system for NRT, which may have advantages over existing systems 4.
- Kratom is not mentioned in any of the provided studies.
- The studies focus on the treatment of tobacco dependence and smoking cessation, and do not provide information on the health effects of ingested kratom.
- Therefore, it is not possible to determine which is healthier based on the provided evidence.
Health Effects of Nicotine and Kratom
- Nicotine is a well-studied substance with known health effects, including addiction and potential harm to cardiovascular and respiratory health 2, 3, 5.
- Kratom, on the other hand, is not well-studied, and its health effects are not fully understood.
- Without further research, it is not possible to compare the health effects of buccal nicotine and ingested kratom.
Treatment of Tobacco Dependence
- The studies provide evidence for the effectiveness of NRT, including buccal nicotine, for smoking cessation 2, 3, 4, 6.
- Combination pharmacotherapy, including NRT and other medications, may be effective for highly nicotine-dependent smokers 2, 6.
- Cognitive behavioral therapy (CBT) plus pharmacotherapy may be an effective treatment approach for smoking cessation, especially for patients with mental disorders 6.