BETEL-QUID AND ARECA-NUT CHEWING - IARC Monographs

BETEL-QUID AND ARECA-NUT CHEWING
1.1 Composition of betel quid
1. Exposure Data
Areca-nut/betel-leaf/tobacco chewing habits are widely prevalent in many parts of
Asia and in migrant communities arising therefrom. Many betel-quid products in different
parts of the world are not actually chewed; rather, they are placed in the mouth or applied
to the oral cavity and remain in contact with the oral mucosa. Nevertheless, it is recommended
that they all be considered as part of the betel-quid chewing habit. Given the
varied ingredients and combinations used in different parts of the world, an accurate
description of terms is essential (see Glossary A for definitions and synonyms).
1.1.1 Betel quid
The term ‘betel quid’ is often used with insufficient attention given to its varied
contents and practices in different parts of the world. A ‘betel quid’ (synonymous with
‘pan’ or ‘paan’) generally contains betel leaf, areca nut and slaked lime, and may contain
tobacco. Other substances, particularly spices, including cardamom, saffron, cloves,
aniseed, turmeric, mustard or sweeteners, are added according to local preferences. In
addition, some of the main ingredients (tobacco, areca nut) can be used by themselves or
in various combinations without the use of betel leaf. Numerous commercially produced
mixtures containing some or all of these ingredients are also available in various parts of
the world. A consensus workshop held in 1996 (Zain et al., 1999) recommended that the
term ‘quid’ should be defined as ‘a substance, or mixture of substances, placed in the
mouth […], usually containing at least one of the two basic ingredients, tobacco or areca
nut, in raw or any manufactured or processed form.’
A chewing substance may primarily consist of (Table 1):
• areca nut alone, without any betel leaf, slaked lime or tobacco
• chewing tobacco without any areca nut
• areca nut with components of betel vine and any other ingredients except tobacco
(betel quid without tobacco)
• areca nut with components of betel vine and any other ingredients including
tobacco (betel quid with tobacco).
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