BETEL-QUID AND ARECA-NUT CHEWING - IARC Monographs

their quid (Warnakulasuriya, 1992). In a nationwide survey conducted between 1994 and
1995 (Ministry of Health, 1998), approximately 4000 adults over the age of 35 years were
interviewed on their betel-quid chewing habits. The prevalence of betel-quid chewing was
[33.8%] among those aged 35–44 years and [47.7%] among those aged 65–74 years. In
another study, the average number of quids used per day was 5.5 (Topcu et al., 2002).
1.3.5 Maldives
In a study of 344 schoolchildren aged 5–15 years, 31% chewed ‘betel’ daily, 48%
chewed occasionally and 21% did not chew. The prevalence of daily chewing for ages
5–6, 10 and 15 years was 15, 27 and 51%, respectively (Knudsen et al., 1985). [The habit
was not described in detail.]
1.3.6 People’s Republic of China
BETEL-QUID AND ARECA-NUT CHEWING 63
Betel-quid chewing is popular in the south-eastern part of China, particularly in the
Hunan Province and on Hainan Island (Tang et al., 1997). In Xiangtan City, Hunan
Province, fresh areca fruit is imported from Hainan Island and is treated with maltose and
lime. The nut is cut longitudinally into four or six pieces and is usually chewed with a few
drops of cassia twig oil (Tang et al., 1997). On Hainan Island, the fruit is chewed fresh
with lime and wrapped in betel leaf (Pindborg et al., 1984). In neither region is tobacco
added to the quid.
An epidemiological survey was conducted in Xiangtan City in over 10 000 randomly
selected subjects (Tang et al., 1997). Just over one third of the population sample chewed
betel quid (Table 25). Among the chewers, 32% of the men and 97% of the women did
not have a smoking habit.
Of 100 betel-quid chewers in the Linshui district of Hainan, 42 chewed betel quid
alone, 31 chewed betel quid and smoked cigarettes, 21 chewed betel quid and smoked a
Table 25. Prevalence of tobacco and areca-nut habits
among randomly selected subjects in Xiangtan City,
Hunan Province, China
Habit Men (%) Women (%) Total (%)
No habit 50.6 69.2 59.0
Areca nut 12.6 29.6 20.3
Smoking 10.0 0.3 5.6
Areca nut + smoking 26.8 0.9 15.1
Total 100 100 100
From Tang et al. (1997)