BETEL-QUID AND ARECA-NUT CHEWING - IARC Monographs

BETEL-QUID AND ARECA-NUT CHEWING 77
Table 32. Prevalence of areca-nut and betel-quid chewing by adolescent Asian
ethnic groups resident in the United Kingdom
Reference Region No. of
samples
Osman
et al. (1997)
Farrand
et al. (2001)
Prabhu
et al. (2001)
Age range
(years)
Examining distinct ethnic groups interviewed in this study, it is clear that Sikhs from
either the first or second generation do not indulge in tobacco or betel-quid chewing while
the Hindus from both generations continue chewing betel quid or pan masala in their
country of residence. Muslims and Jains of the second generation, on the other hand, were
less likely to chew these products.
(i) Tobacco in betel quid
Community Habit Prevalence
(%)
Luton 1058 11–16 Mixed Asian Betel quid a
London,
East
London,
East
a Betel quid with or without tobacco
204 12–18 Bangladeshi Betel quid a
Men
Women
With tobacco
704 11–15 70% Bangladeshi Areca nut 77
In the three studies of adolescents quoted above, the majority began chewing betel
quid without tobacco but some converted to adding tobacco to the quid during senior
school ages or used commercially packaged products, which predominantly contained
areca nut and tobacco (gutka). The social pressures on young Bangladeshi women in the
United Kingdom to introduce chewing tobacco to their betel quid are presented by Bedi
and Gilthorpe (1995). Among older Asian adults, up to 50% are recorded as adding
tobacco to the betel quid when this was made up at home according to their own recipe.
For older Bangladeshi women, it may reach close to 90% (Rudat, 1994; Bedi, 1996). A
further proportion predominantly chewed sweetened tobacco products such as zarda.
With the emergence of commercially packaged areca products, it is increasingly difficult
to disentangle the effect of tobacco, as these products are often mixtures of sun-dried
tobacco and cured areca nut.
(ii) Determinants of chewing habits among Asians
Ethnic variations in the chewing of betel quid and tobacco among Asian migrants in
the United Kingdom are recognized in several studies. The predominant group retaining
chewing habits in Britain are Bangladeshi adults (Williams et al., 2002). Socioeconomic
status and education certainly seem to have effects on the prevalence of the habit. Among
Indians, people who are educated beyond the age of 16 years are more likely to chew
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