BETEL-QUID AND ARECA-NUT CHEWING - IARC Monographs

adolescents have less access to the sometimes scarce leaf or they may wish to avoid the
reddened saliva and stained teeth caused by chewing the leaf to escape detection of their
habit by disapproving authorities and institutions.
1.3.18 Guam
Chewing areca nut (pugua) is an old tradition in Guam, particularly among the native
Chamorro people (Gerry et al., 1952). Islanders prefer the hard reddish variety of nut but
citizens of Micronesia prefer a soft (unripe) areca nut that is succulent and gelatinous
(Anon., 2003).
Another account of the chewing habits of Guamanians in 1986 reported that indigenous
people chewed either the entire fresh green areca fruit (nut, husk and skin) or the
areca nut together with betel leaf. Slake lime is not used during chewing, nor is tobacco
(Stich et al., 1986). A comparison with previous reports indicated that this practice had
not changed over the last 40–50 years.
1.3.19 Others
BETEL-QUID AND ARECA-NUT CHEWING 73
Table 29. Proportion of betel-quid chewers and of
ingredients used among residents of Palau
Proportion
chewing
Proportion (%) of chewers using
(%) Betel leaf Slaked lime Tobacco
Age (years)
5–14 55 48 a 99 87
15–24 77 51 99 96
25–34 86 84 100 88
35–44 89 94 99 72
45–54 82 96 99 68 a
55–64 77 a 100 100 58 a
65–74 86 a 96 100 65 a
> 74 84 a 100 100 76 a
Men 72 73 100 81
Women 80 75 99 84
Total no. 845 624 840 700
From Ysaol et al. (1996)
a Maximum error exceeds 9% at p < 0.05. All other proportions have
a maximum error of less than 9% at p < 0.05.
In various countries, including Nepal, Viet Nam, Kenya and the Solomon Islands, the
habit of chewing betel quid or areca nut is known, but no reports are available.