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Betel nut chewing

Betel nut chewing, also called betel quid chewing or areca nut chewing, is a practice in which areca nuts are chewed together with slaked lime and betel leaves for their stimulant and narcotic effects, the primary psychoactive compound being arecoline. The practice is widespread in Southeast Asia, Micronesia, Island Melanesia, and South Asia. It is also found among both Han Chinese immigrants and indigenous peoples of Taiwan, Madagascar, and parts of southern China. It was introduced to the Caribbean in colonial times.

Culture
One of the earliest firsthand accounts of betel nut chewing by western authors was from Ibn Battuta. He describes this practice as follows: () of the Philippines, showing an areca palm with fruits, captioned Bongas con que se hace el buyo de que usa todo genero de gentes mascádolo como tabaco ("Fruits from which one makes buyo, which is used by every sort of people, who chew it like tobacco") An early European description of betel chewing is from the Magellan Expedition to the Philippines in 1521. Antonio Pigafetta describes the practice of betel nut chewing among the natives of the Rajahnate of Butuan. Betel quid chewing constitutes an important and popular cultural activity in many Asian and Oceanic countries, including Bangladesh, Myanmar, Cambodia, the Solomon Islands, Thailand, the Philippines, Laos, and Vietnam. Chewing betel was once common in Malaysia, but the practice has long since died out. Betel nut kits (tepak sirih) made of silver and other precious metals, once featured in royal regalia and presented as wedding gifts, have become collector's items, and a tepak sirih set is featured on the 1989–2012 series Malaysian 20-sen coin. In urban areas, paan is generally considered a nuisance because some chewers spit the betel quid juice out in public areas. The combination of ingredients when chewed is known to make a colourful stain. This is becoming an unwanted eyesore in Indian cities such as Mumbai. This is also common in some of the Persian Gulf countries, such as the UAE and Qatar, where many Indians live. In 2008 the Dubai government banned the import and sale of betel quid and the like. According to traditional Ayurvedic medicine, chewing betel leaf is a remedy against bad breath (halitosis). Cambodia, Laos and Thailand The chewing of the product is part of the culture of Cambodia, Laos, and Thailand. Cultivation of areca nut palm and betel leaves is common in rural areas of these countries, being a traditional cash crop, and the utensils used for preparation are often treasured. Now, many young people have given up the habit, especially in urban areas, but many, especially older people, still keep to the tradition. Bangladesh In Bangladesh, paan is chewed throughout the country by all classes and is an important element of Bangladeshi culture. It is the Bangladeshi 'chewing gum', and usually for chewing, a few slices of the betel nut are wrapped in a betel leaf, almost always with sliced areca nuts and often with calcium hydroxide (slaked lime), and may include cinnamon, clove, cardamom, catechu (khoyer), grated coconut and other spices for extra flavouring. As it is chewed, the peppery taste is savoured, along with the warm feeling and alertness it gives, similar to drinking a fresh cup of coffee. Paan-shupari (shupari for areca nut) is a veritable Bangladeshi archetypal imagery, employed in wide-ranging contexts. Prior to British rule, it was chewed without tobacco, and it is still rarely chewed with tobacco. Betel leaves are arranged aesthetically on a decorated plate called paandani. During the zamindari age, paan preparation and the style of garnishing it on a plate (paandani) was indeed a recognised folk art. In Bangladesh paan is traditionally chewed not only as a habit but also as an item of rituals, etiquette and manners. On formal occasions offering paan symbolized the time for departure. In festivals and dinners, in pujas and punyas paan is an indispensable item. Hindus make use of paans as offerings in worship. Dhakai Khilipan, a ready pack of betel leaf processed in Dhaka is famous in the sub-continent. Old Dhakaites have a rich heritage of creating the best khili paan with many complexes, colourful, aromatic and flavorful ingredients. Although 'paan' has been a staple Bengali custom for ages, a number of high-end stores with premium quality paan has become available in recent times. Paan Supari is perhaps the first such brand, which offers a wide range of khili paan. They also offer a khili paan for diabetic patients called the "paan afsana". It has become a ritual, tradition and culture of Bangladeshi society. Adult women gather with paandani along with friends and relatives in leisure time. Total cultivated area under the crop in Bangladesh is about 14,175 ha and the total annual production is about 72,500 tons. The average yield per acre is 2.27 tons. There are usually three crops during the twelve months, and they are locally called by the name of the respective months in which they are harvested. Paan leaf is usually plucked in Kartik (October), Phalgun (February) and Ashad (June). The Kartik paan is considered by consumers to be the best and Ashad paan the worst. When plucking, it is a rule to leave at least sixteen leaves on the vine. Betel leaf used is produced in different parts of India. Some states that produce betel leaf for paan include West Bengal, Bihar, Assam, Andhra Pradesh, Uttar Pradesh. In West Bengal, two types of betel leaves are produced. These are Bangla patta (Bengali leaf/Country Leaf) and Mitha patta (Sweet Leaf). In West Bengal, Bangla patta is produced mainly in district of Dinajpur, Malda, Jalpaiguri, and Nadia. Mitha patta is produced in places such as Midnapur and South 24 Parganas. The skilled paan maker is known as a paanwala in North India. In other parts, paanwalas are also known as panwaris or panwadis. In the Indian state of Maharashtra, the paan culture is widely criticised due to the cleanliness problems created by people who spit in public places. In Mumbai, there have been attempts to paint pictures of Hindu gods in places where people commonly tend to spit, in the hope that this would discourage spitting, but success has been limited and there is need a solution at root to avoid peek. One of the great Marathi artists P L Deshpande wrote a comic story on the subject of paanwala (paan vendor) and performed a televised reading session on Doordarshan during the 1980s in his unique style. Paan is losing its appeal to farmers because of falling demand. Consumers prefer chewing tobacco formulations such as gutka over paan. Higher costs, water scarcity and unpredictable weather have made betel gardens less lucrative. According to StraitsResearch, The India pan masala market is expected to reach US$10,365 million by 2026 at the CAGR of 10.4% during the forecast period 2019–2026. The India pan masala market is driven by significant switching of consumers from tobacco products to pan masala, aggressive advertising and convenient packaging, and Maharashtra State's revocation of the ban over pan masala products. Assam In Assam, India, betel nut is traditionally offered as a mark of respect and auspicious beginnings. Paan-tamul (betel leaves and raw areca nut) may be offered to guests after tea or meals, served in a brass plate with stands called bota. The areca nut also appears as a fertility symbol in religious and marriage ceremonies. When showing respect to elders or asking for forgiveness, people, especially newlyweds place a pair of paan-tamul on a xorai, place it in front of the elders and bow to show respect. Guests may be invited to a wedding reception by offering a few areca nuts with betel leaves. During Bihu, the husori players are offered areca nuts and betel leaves by each household while their blessings are solicited. Paan-tamul is also offered to guests after the end of every feast, usually the paan-tamul-soon, or slaked lime with cardamom pods in it to freshen the breath. Banarasi Paan Banarasi paan of Banaras (Varanasi) is widely famous among Indians and tourists visiting India. Indonesia and Malaysia Bersirih, nyirih, or menginang is a historical Malayonesian tradition of chewing materials such as nut, betel, gambier, tobacco, clove, and limestone. In the Malay Archipelago, the menginang or betel nut chewing has become a revered activity in local tradition; being a ceremoniously conducted gesture to honour guests. A complete and elaborate set of sirih pinang equipment is called tepak, puan, pekinangan, or cerana. The set is usually made of wooden lacquerware, brass or silverwares; and it consists of the combol (containers), bekas sirih (leaf container), kacip (press-knife to cut areca nut), gobek (small pestle and mortar), and ketur (spit container). Areca palms have been grown traditionally in Guam, Palau, and Yap since ancient times. It spread to Chuuk in modern times. Betel nut stains have been found in ancient remains of the Chamorro people, indicating that the practice was carried into Micronesia by their Austronesian ancestors in Island Southeast Asia. Betel chewing has very long tradition in Burma, having been practised since before the beginning of recorded history. Until the 1960s, both men and women loved it and every household used to have a special lacquerware box for betel quid, called kun-it (), which would be offered to any visitor together with cheroots to smoke and green tea to drink. The leaves are kept inside the bottom of the box, which looks like a small hat box, but with a top tray for small tins, silver in well-to-do homes, of various other ingredients such as the betel nuts, slaked lime, cutch, anise seed and a nut cutter. Other parts of the country contribute to the best betel quid according to another saying "Tada-U for the leaves, Ngamyagyi for the tobacco, Taungoo for the nuts, Sagaing for the slaked lime, Pyay for the cutch". Kun, hsay, lahpet (betel quid, tobacco and pickled tea) are deemed essential items to offer monks and elders particularly in the old days. Young maidens traditionally carry ornamental betel boxes on a stand called kundaung and gilded flowers (pandaung) in a shinbyu (novitiation) procession. Burmese history also mentions an ancient custom of a condemned enemy asking for "a betel quid and a drink of water" before being executed. An anecdotal government survey indicated that 40% of men and 20% of women in Myanmar chew betel. An aggregate study of cancer registries (2002 to 2007) at the Yangon and Mandalay General Hospitals, the largest hospitals in the country, found that oral cancer was the 6th most common cancer among males, and 10th among females. Of these oral carcinoma patients, 36% were regular betel quid chewers. Effective 29 July 2007, betel chewing, along with smoking, has been banned from the Shwedagon Pagoda, the country's most important religious site. In 2010, the Ministry of Education's Department of Basic Education and Burma's Anti-Narcotics Task Force collaborated to prohibit betel shops from operating within of any school. Nepal Paan is chewed mainly by Terai people, although migrants in Terai have also taken up chewing paan in recent times. Throughout Terai, paan is as common as anywhere in northern India. There is some local production, generally not commercial, but most leaves are imported from India. Although not as ubiquitous as in the Terai, most residents of Kathmandu occasionally enjoy paan. A sweet version of paan called meetha paan is popular amongst many who do not like the strong taste of plain (sada) paan. Some parents allow their children to consume meetha on special occasions because it is tobacco-free. Pakistan The consumption of paan has long been a very popular cultural tradition in Pakistan, especially in the port city of Karachi, although the tradition is dying among the younger generation. In general, though, paan is an occasional delicacy thoroughly enjoyed by many, and almost exclusively bought from street vendors instead of any preparations at home. Pakistan grows a large variety of betel leaf, specifically in the coastal areas of Sindh, although paan is also imported in large quantities from Bangladesh and Sri Lanka. In the famous Anarkali Bazar in Lahore a street called paan gali is dedicated for paan and other Pakistani products. The rate of oral cancer has grown substantially in Pakistan due to chewing of paan. Philippines Betel nut chewing was formerly widespread among the ethnic groups of the Philippines. The country is where the areca palm (Areca catechu) is originally native to and where the tradition started before being spread via the Austronesian expansion (see history section). The Philippines also has the highest genetic diversity in Areca catechu populations and is home to several closely related Areca palm species, In modern times, it has gone out of favor and has been replaced by cigarettes and chewing gum. The practice only survives among more remote ethnic groups like the Cordillerans of Luzon, and the Lumad and Moro people of Mindanao. In the native languages of the Philippines, betel nut chewing is known variously as buyo, bunga, hitso, or ngangà in Tagalog, Bikol, and the Visayan languages; dapiau in Ivatan; and bua, mama or maman in Ilocano; luyos in Kapampangan; pasa in Basilan; and lugos in Zamboanga; among other names. Vietnam In Vietnam, the areca nut and the betel leaf are such important symbols of love and marriage that in Vietnamese the phrase "matters of betel and areca" (chuyện trầu cau) were historically synonymous with marriage. Areca nut chewing starts the talk between the groom's parents and the bride's parents about the young couple's marriage. Therefore, the leaves and juices are used ceremonially in Vietnamese weddings. ==Health effects==
Health effects
Chewing betel quids and areca nut causes multiple forms of cancer and cardiovascular disease, with or without tobacco. Betel nut chewing causes an increased risk of head and neck cancers and esophageal cancer. Betel quid affects almost all parts of the human body, including the brain, heart, lungs, gastrointestinal tract and reproductive organs. It can cause myocardial infarction, cardiac arrhythmias, liver damage, asthma, type II diabetes, hyperlipidemia, metabolic syndrome, hypothyroidism, prostate hyperplasia and infertility. When chewed with additional tobacco in its preparation (like in gutka), there is an even higher risk for cancer, especially for oral and oropharyngeal cancers. It is estimated that around 600 million people worldwide regularly use this drug preparation. A recent study introduced the betel year, a novel metric designed to quantify lifetime exposure to betel quid chewing and enhance oral cancer risk prediction through personalized assessment. This tool helps identify high-risk individuals and supports targeted public health initiatives, including awareness campaigns and early detection programs. It may also inform policy development and ongoing epidemiological research. As an initial pilot effort, the betel year is a starting point, with further studies needed to explore the carcinogenic potential of other additives globally and refine the metric for wider use. ==History==
History
illustrated by Francisco Manuel Blanco in Flora de Filipinas'' (1880–1883). It is native to the Philippines. Based on archaeological, linguistic, and botanical evidence, betel chewing is most strongly associated with the Austronesian peoples. Chewing betel generally requires the combination of areca nut (Areca catechu) and betel leaf (Piper betle). Both plants are native from the region between Island Southeast Asia to Australasia. A. catechu is believed to be native to the Philippines, where it has the greatest morphological diversity as well as the most closely related endemic species. The origin of the domestication of Piper betle, however, is unknown, although it is also native to the Philippines, the Lesser Sunda Islands, and Indochina. It is also unknown when or why the two plant products were combined, as areca nut alone can be chewed as a stimulant. The oldest unequivocal evidence of betel chewing is from the Philippines. Specifically that of several individuals found in a burial pit in the Duyong Cave site of Palawan island dated to around 4,630±250 BP. The dentition of the skeletons is stained, typical of betel chewers. The grave also includes Anadara shells used as containers of lime, one of which still contained lime. Burial sites in Bohol dated to the first millennium CE also show the distinctive reddish stains characteristic of betel chewing. Based on linguistic evidence of how the reconstructed Proto-Austronesian term *buaq, meaning "fruit", came to refer to the "areca nut" in Proto-Malayo-Polynesian, it is believed that betel chewing originally developed somewhere within the Philippines shortly after the beginning of the Austronesian expansion (~5,000 BP). From the Philippines, it spread back to Taiwan, as well as onwards to the rest of Austronesia. It was also previously present in the Lapita culture, based on archaeological remains from Mussau dated to around 3,600 to 2,500 BP. But it did not reach Polynesia further east. It is believed that it stopped in the Solomon Islands due to the replacement of betel chewing with the tradition of kava drinking prepared from the related Piper methysticum. It was also diffused into East Africa via the Austronesian settlement of Madagascar and the Comoros by around the 7th century. Chinese records, specifically Linyi Ji by Dongfang Shuo associate the growing of areca palms with the first settlers of the Austronesian Champa polities in southern Vietnam at around 2,100 to 1,900 BP. This association is echoed in Nanfang Cao Mu Zhuang by Ji Han (c. 304 CE) who also describes its importance in Champa culture, specifically in the way Cham hosts traditionally offer it to guests. Betel chewing entered China through trade with Champa, borrowing the Proto-Malayo-Chamic name *pinaŋ resulting in Chinese bin lang for "areca nut", with the meaning of "honored guest", reflecting Chamic traditions. The same for the alternate term bin men yao jian, literally meaning "guest [at the door] medicinal sweetmeat". ==See also==
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