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| PATIENT'S
GUIDE > ARECA NUT, BETEL NUT, PAAN AND GUTKA |
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In addition to the risk factors of smoking and chewing tobacco, oral
cancer occurs more frequently among
African Americans than among Caucasians
and among people who chew areca nuts, betel nuts, paan and gutka
(a common practice among some people
in India and Asia).
Paan tends to refer to the glossy heart-shaped betel (Piper betel) pepper spice leave, which is not botanically related to the betel nut palm (Areca catechu) which is added as slivers, to it along with some lime (calcium hydroxide) to better extract the alkaloids in the nut. Some people also chew tobacco with it. After about 20 minutes of chewing, the fibrous residue which remains of the nut is often spat on the street, where it remains visible due to its characteristic bright red colour. Regular betel chewing causes the teeth and gums to be stained red. In the past people chewed betel, paan or beeda to make their teeth look red which was considered a symbol of beauty. In Asia it has been considered a symbol of beauty and attraction and a measure of taste. According to botanists betel leaf first grew in Malaysia. It is believed that people of Northern Thailand chewed betel leaf with lemon and betel nut. From there the habit spread to other neighbouring countries and finally became an integral part of India's lifestyle. Betel chewing is addictive. Historically a betel quid (paan) was often formulated to an individual's wishes but nowadays readymade packets of these products are now available as a proprietary mixture known as paan masala. Paan masala tends to contain tobacco products. Read more...
People chewing tobacco in paan are over five times more likely to be at risk of oral cancer. The International Agency for Research on Cancer (IARC) now regards the betel nut itself to be a known human carcinogen. In making this new finding, the working group had available recent epidemiological studies from India and Pakistan which allowed to disentangle the effect of betel quid with and without tobacco, and studies from Taiwan (China), where tobacco is not added to the betel quid. Studies on betel quid without tobacco and areca nut without tobacco in experimental animals now also provide sufficient evidence of carcinogenicity.
The best way to avoid these cancers is to never start chewing tobacco, paan or betel nut. |
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Giving
up Tobacco: Helping South Asian Communities
Giving up tobacco use - whether you
smoke cigarettes or bidi, chew tobacco
in paan or gutkha - is probably the
single best thing you can do for your
health and for those around you. Use
the NHS Asian Tobacco Helplines to speak
to an expert confidentially in your
own language. |
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Betel
Quid (Paan) and Oral Cancer
British Asians have brought the use
of areca from India (some via East Africa),
Pakistan, Bangladesh, and other countries
in the region and its use is thus firmly
culturally bound. Historically a betel
quid (paan) was often formulated to
an individual's wishes but now readymade
packets of these products are now available
as a proprietary mixture known as paan
masala. This article examines the
relation between areca nut use and the
development of mouth cancer. |
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India: Mouth cancer epidemic on the way
In India, doctors are reporting a rise in pre-cancerous lesions in the mouth - which they're convinced are caused by chewing tobacco. They are worried about the surging popularity of chewable or smokeless tobacco, particularly among the young. Children started using gutkha six or seven years ago. Mouth cancer has a ten-year incubation period, so they fear a huge bout of oral cancer will hit India in a few years time. |
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Asian chewing habit linked to oral cancer
Several hundred million people today practice the ancient custom of chewing betel. In south Asia, where the habit is most prevalent, the signs are hard to miss. Placed inside the cheek and sucked for hours, a betel wad turns saliva bright red, and betel users' spit does likewise to sidewalks and streets. |
After India, Taiwan is the world's second-largest producer of betel nuts
About 70,000 cancer cases are detected in Taiwan each year, with 6 percent to 8 percent involving betel-nut chewers. Aborigines account for a larger percentage of the betel-nut chewing population. Of the 10 percent of betel-nut chewers in Taiwan, 40 percent were Aborigines.
Study highlights cancer risks from betel-nut chewing
The National Health Research Institute sent an alarming message yesterday to the nation's betel-nut chewers: If they also smoke and drink, they are 195 times more likely to contract cancer of the esophagus than those who do not. They are also 96.9 times more likely to get cancer of the pharynx and 40.3 times more likely to contract cancer of the larynx.
Taiwan's 60,000 Betel-Nut Beauties Thwart Effort to Curb Cancer
Jan. 27 (Bloomberg) -- The Taiwan government's plan to curb cancer faces tough opposition: about 60,000 women who sit in roadside glass booths, often wearing little more than a bikini, selling the island's oldest legal drug.
See why the Taiwan health authorities were so pessimistic about getting people to stop this habit: photos
Areca Nut Use: An Independent Risk Factor for Oral Cancer
The Health Problem is Under-recognised
"... Most people perceive [areca nut] solely as a cultural factor and they have no knowledge of the fact that there is any harm caused by this product. We are planning a UK health educational programme and have set up a charitable trust called Areca Concern through which we want to provide educational leaflets and material," adds Warnakulasuriya.
'Traditional' tobacco chewing causes 3,000 deaths in the UK alone
Oral Cancer fear for Asians, 3 March 2003, BBC News.
A charity called 'Areca Concern' has been established by Chetan Trevidy to increase awareness of the threat caused by chewing tobacco and particularly the areca nut, amongst the Asian community. Oral cancer accounts for 3,000 deaths in the UK every year and Trevidy, an honorary clinical research fellow at Northwick Park Hospital in London links these to the century old Indian and particularly Hindi tradition of chewing areca. Areca, which is often chewed with tobacco is highly addictive and Trevidy says there are inadequate health warnings, insufficient public awareness and no substitute products. According to a study conducted by Trevidy of areca use in North West London, areca was found to be addictive as amphetamines.
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