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Betel nut chewing

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(Redirected fromPaan)
Preparation of betel leaf and areca nut
"Paan" redirects here. For the city in Myanmar, seePa-an.

Ghiyas al-Din eats a betel chew, illustration from theNimatnama-i-Nasiruddin-Shahi.Malwa,c. 1500.British Library
The items used in a chewing session. Thebetel leaves are folded. Slices of the dryareca nut are on the upper left. Slices of the tender areca nut are on the upper right. The pouch on the right has tobacco, an optional element. On the lower right, there are driedcloves.
Betel leaves at a market inMandalay,Burma
This article containsBurmese script. Without properrendering support, you may seequestion marks, boxes, or other symbols instead ofBurmese script.

Betel nut chewing, also calledbetel quid chewing orareca nut chewing, is a practice in whichareca nuts (also called "betel nuts") are chewed together withslaked lime andbetel leaves for theirstimulant andnarcotic effects, the primary psychoactive compound beingarecoline. The practice is widespread in Southeast Asia,Micronesia,Island Melanesia, and South Asia. It is also found among bothHan Chinese immigrants and indigenous peoples ofTaiwan,Madagascar, and parts of southern China. It was introduced to theCaribbean in colonial times.[1][2]

The preparation combining the areca nut,slaked lime, and betel (Piper betle) leaves is known as abetel quid (also calledpaan orpan in South Asia), but the exact composition of the mixture varies geographically.[3] It can sometimes include other substances for flavoring and to freshen the breath, likecoconut,dates, sugar,menthol,saffron,cloves,aniseed,cardamom, and many others. The areca nut can be replaced with tobacco or the two chewed together, and thebetel leaves can be excluded. In West Papua, the leaf may be replaced with stem and inflorescence of thePiper betle plant.[4] The preparation is not swallowed but is spat out after chewing. Chewing results in permanent red stains on the teeth after prolonged use. The spit from chewing betel nuts, which also results in red stains, is often regarded as unhygienic and an eyesore in public facilities in certain countries.[1][5][6]

Betel nut chewing is addictive and causes adverse health effects, mainlyoral andesophageal cancers, and cardiovascular disease.[6][1] When chewed with additional tobacco in its preparation (like ingutka), there is an even higher risk, especially for oral andoropharyngeal cancers.[7] With tobacco it also raises the risk of fatalcoronary artery disease, fatal stroke,[8][9] and adverse reproductive effects includingstillbirth,premature birth andlow birth weight.[10]

The practice of betel nut chewing originates from Southeast Asia where the plant ingredients are native. The oldest evidence of betel nut chewing is found in a burial pit in theDuyong Cave site of thePhilippines, an area whereareca palms were native, dated to around 4,630±250BP. Its diffusion is closely tied to theNeolithic expansion of theAustronesian peoples. It was spread to the Indo-Pacific during prehistoric times, reachingMicronesia at 3,500 to 3,000 BP,Near Oceania at 3,400 to 3,000 BP;South India andSri Lanka by 3,500 BP;Mainland Southeast Asia by 3,000 to 2,500 BP;Northern India by 1500 BP; andMadagascar by 600 BP. From India it spread westwards toPersia and theMediterranean. It was present in theLapita culture, based on archaeological remains dated from 3,600 to 2,500 BP, but it was not carried intoPolynesia.[11]

Culture

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A map of global Betel leaf and areca nut consumption[citation needed]

One of the earliest firsthand accounts of betel nut chewing by western authors was fromIbn Battuta. He describes this practice as follows:[citation needed]

The betel is a tree which is cultivated in the same manner as the grape-vine; ... The betel has no fruit and is grown only for the sake of its leaves ... The manner of its use is that before eating it one takes areca nut; this is like a nutmeg but is broken up until it is reduced to small pellets, and one places these in his mouth and chews them. Then he takes the leaves of betel, puts a little chalk on them, and masticates them along with the betel.

Detail from theMurillo Velarde map (c.1734) of thePhilippines, showing anareca palm with fruits, captionedBongas con que se hace el buyo de que usa todo genero de gentes mascádolo como tabaco ("Fruits from which one makesbuyo, which is used by every sort of people, who chew it like tobacco")

An early European description of betel chewing is from theMagellan Expedition to thePhilippines in 1521.Antonio Pigafetta describes the practice of betel nut chewing among the natives of theRajahnate of Butuan.[12]: 146 

Those people are constantly chewing a fruit which they call "areca", and which resembles a pear. They cut that fruit into four parts, and then wrap it in the leaves of their tree [sic] which they call "betre". Those leaves resemble the leaves of the mulberry. They mix it with a little lime, and when they have chewed it thoroughly, they spit it out. It makes the mouth exceedingly red. All the people in those parts of the world use it, for it is very cooling to the heart, and if they ceased to use it they would die.

— Antonio Pigafetta,Relazione del primo viaggio intorno al mondo (1521)

Betel quid chewing constitutes an important and popular cultural activity in many Asian and Oceanic countries, includingIndia,Bangladesh,Myanmar,Cambodia, theSolomon Islands,Thailand, thePhilippines,Laos, andVietnam.[13] Chewing betel was once common inMalaysia, 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 collectors' items, and atepak sirih set is featured on the 1989–2012 series Malaysian 20-sen coin.[14]

In urban areas, chewing betel quid is generally considered a nuisance because some chewers spit the betel quid juice out in public areas – comparechewing gum ban in Singapore andsmoking ban. The red stain generated by the combination of ingredients when chewed are known to make a colourful stain on the ground. This is becoming an unwanted eyesore in Indian cities such as Mumbai, although many see it as an integral part of Indian culture. This is also common in some of the Persian Gulf countries, such as the UAE and Qatar, where many Indians live. Recently, the Dubai government has banned the import and sale of betel quid and the like.[15]

According to traditionalAyurvedic medicine, chewing betel leaf is a remedy against bad breath (halitosis).[16]

Cambodia, Laos and Thailand

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The chewing of the product is part of theculture of Cambodia,Laos, andThailand. Cultivation of areca nut palm and betel leaves is common in rural areas of these countries, being a traditionalcash 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.[citation needed]

  • A statue of a hermit with an offering of betel quid from Thailand
    A statue of a hermit with an offering of betel quid fromThailand
  • A Betel preparation kit in Bangkok, Thailand
    A Betel preparation kit inBangkok, Thailand
  • A woman in Southern Laos with the characteristic red-stained teeth and gums from chewing betel nut
    A woman in Southern Laos with the characteristic red-stained teeth and gums from chewing betel nut

Bangladesh

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InBangladesh,paan is chewed throughout the country by all classes and is an important element of Bangladeshi culture. It is the Bengali '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.

Whole and sliced Areca nut with other betel nut chewing components from a Bangladeshi bazar

Paan-shupari (shupari being Bengali 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 calledpaandani. During thezamindari 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".

The sweet paan of theKhasi tribe is famous for its special quality. Paan is also used inHindupuja and wedding festivals and to visit relatives. It has become a ritual, tradition and culture of Bangladeshi society. Adult women gather with paandani[17] 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, Phalgun and Ashad. 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.[17]

Different varieties of betel leaf are grown, and the quality differs in shape, bleaching quality, softness, pungency and aroma of leaf. Tamakh paan, a betel leaf blended with tobacco and spices. Supari paan, another variety of white leaf, Mitha paan, a sweet variety, and Sanchi paan are common varieties of betel leaves. Almost every paan-producing district has its own special variety of betel leaf of which consumers are well acquainted. In the past, the best quality of elegant camphor-scented betel leaf named Kafuri paan was produced in the Sonargaon area of Narayangonj district. It was exported to Calcutta and Middle Eastern countries.[17]

The next best is the Sanchi paan grown in Chittagong hill tracts. This variety is not very popular among Bangali people. It is exported to Pakistan for the consumers of Karachi. The commoner varieties are called Desi, Bangla, Bhatial, Dhaldoga, Ghas paan. Bangla paan, is also known as Mitha paan, Jhal paan or paan of Rajshahi. At present, this variety is becoming extinct, due to emergence of more profitable and lucrative fast-growing varieties of paan crops. Normally, betel leaves are consumed with chun, seed cinnamon, cardamoms and other flavored elements.[17]

China

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This section is an excerpt fromBetel chewing in China.[edit]
Dried and chopped betel nut,Hunan province
Betel chewing in China has a long history, particularly in the southern provinces. In modern times, betel nut chewing is popular nationwide. The social debate over betel nut chewing has led the authorities to introduce some restriction policies, though almost all cities in the country still allow the production, sale, and consumption of betel nut.

India

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In a 16th-century cookbook,Nimatnama-i Nasiruddin-Shahi, describes Ghiyas-ud-dinKhalji, the Sultan ofMandu (r. 1469–1500), watches as tender betel leaves of the finest quality are spread out and rosewater is sprinkled on them, while saffron is also added. An elaborate betel chew or paan would contain fragrant spices and rose preserves with chopped areca nuts.

It is a tradition in South India and nearby regions to give two Betel leaves, areca nut (pieces or whole) and Coconut to the guests (both male and female) at any auspicious occasion. Even on a regular day, it is the tradition to give a married woman, who visits the house, two Betel leaves, areca nut and coconut or some fruits along with a string of threaded flowers. This is referred to asthamboolam. Paan is symbol of Prosperity in indian tradition and part of most of rituals followed.

Use of this drug causes profuse red coloured salivation. This saliva is spat out, yielding stains and biological waste pollution in public spaces. Many countries and municipalities have laws to prevent betel quid spit.[18][19]

Betel leaf used to make paan is produced in different parts of India. Some states that produce betel leaf for paan include West Bengal, Bihar, Assam, Andhra Pradesh, Uttar Pradesh. InWest Bengal, two types of betel leaves are produced. These are "Bangla Patta (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.[citation needed]

The skilled paan maker is known as apaanwala in North India. In other parts,paanwalas are also known aspanwaris orpanwadis. At North India, there is a tradition to chew paan after Deepawali puja for blessings.

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 artistsP L Deshpande wrote a comic story on the subject ofpaanwala (paan vendor) and performed a televised reading session onDoordarshan during the 1980s in his unique style.

Paan is losing its appeal to farmers because of falling demand. Consumers prefer chewing tobacco formulations such asgutka over paan. Higher costs,water scarcity and unpredictable weather have made betel gardens less lucrative.[20]

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.[21]

Assam

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InAssam, 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 ofpaan-tamul on axorai, place it in front of theelder and bow to show respect.

Guests may be invited to a wedding reception by offering a few areca nuts with betel leaves. DuringBihu, thehusori 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 thepaan-tamul-soon, or slaked lime with cardamom pods in it to freshen the breath.

Banarasi Pan

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[icon]
This sectionneeds expansion. You can help byadding to it.(December 2021)

BanarasiPan ofBanaras (Varanasi) is widely famous among Indians and tourists visiting India.[22][23][24]

Indonesia and Malaysia

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Bersirih,nyirih, ormenginang is a historicalMalayonesian tradition of chewing materials such asnut,betel,gambier, tobacco,clove, andlimestone.[25]

In theMalay Archipelago, themenginang 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 ofsirih pinang equipment is calledtepak,puan,pekinangan, orcerana. The set is usually made of wooden lacquerware, brass or silverwares; and it consists of thecombol (containers),bekas sirih (leaf container),kacip (press-knife to cut areca nut),gobek (small pestle and mortar), andketur (spit container).[25]

TheSirih Pinang has become a symbol ofMalay culture,[26][self-published source?] with the Malayoral tradition having phrases such as "The betel opens the door to the home" or "the betel opens the door to the heart".[26]

  • A Javanese woman preparing betel leaf, c. 1880.
    A Javanese woman preparing betel leaf, c. 1880.
  • Balinese cerana or betel nut container.
    Balinesecerana or betel nut container.
  • Betel nut preparation kit (tepak sireh) made from wood inlaid with silver, gold, and mother of pearl from Malaysia (early 20th century)
    Betel nut preparation kit (tepak sireh) made from wood inlaid with silver, gold, andmother of pearl fromMalaysia (early 20th century)
  • Betel nut cutter from Indonesia
    Betel nut cutter from Indonesia

Micronesia

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Betel nut chewing is common among the native ethnic groups ofMicronesia. They can be grouped into two different traditions. The betel nut chewing tradition of theChamorro people of theMariana Islands prefer ripe (red) areca nuts. The betel nut chewing tradition of theChuukese,Palauan, andYapese people, on the other hand, prefer unripe (green) areca nuts. Betel leaf and lime are included in the quid, and commonly tobacco. Flavoring ingredients likeginger,cardamom, andvodka are also sometimes added.[27]

Areca palms have been grown traditionally inGuam,Palau, andYap since ancient times. It spread toChuuk 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.[27]

Myanmar

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Kwun-ya (ကွမ်းယာ [kóːn.jà]) is the word for betel quid inMyanmar, formerly Burma, where the most common configuration for chewing is a betel vine leaf (Piper betel), areca nut (fromAreca catechu), slaked lime (calcium hydroxide) and some spices, although many betel chewers also use tobacco.[28]

Betel chewing has very long tradition in Burma, having been practised since before the beginning of recorded history.[29] Until the 1960s, both men and women loved it and every household used to have a speciallacquerware box for betel quid, calledkun-it (ကွမ်းအစ်), which would be offered to any visitor together withcheroots to smoke andgreen tea to drink.[30] 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.[30]

The sweet form (acho) is popular with the young, but grownups tend to prefer it with cardamom, cloves and tobacco. Spittoons, therefore, are still ubiquitous, and signs saying "No betel quid-spitting" are commonplace, as it makes a messy red splodge on floors and walls; many people display betel-stained teeth from the habit. Betel quid stalls and kiosks used to be run mainly by people of Indian origin in towns and cities. Smokers who want to quit would also use betel nut to wean themselves off tobacco.

Taungoo inLower Burma is where the best areca palms are grown indicated by the popular expression "like a betel lover taken to Taungoo".[31] 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 calledkundaung and gilded flowers (pandaung) in ashinbyu (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.[32] An aggregate study of cancer registries (2002 to 2007) at theYangon andMandalay General Hospitals, the largest hospitals in the country, found thatoral cancer was the 6th most common cancer among males, and 10th among females.[33] Of these oral carcinoma patients, 36% were regular betel quid chewers.[33]University of Dental Medicine, Yangon records from 1985 to 1988 showed that 58.6% of oral carcinoma patients were regular betel chewers.

Since the 1990s, betel chewing has been actively discouraged by successive governments, from theState Law and Order Restoration Council (SLORC) onward, on the grounds of health and tidiness.[29] In April 1995, theYangon City Development Committee banned betel inYangon (Rangoon), in anticipation of Visit Myanmar Year 1996, a massive effort to promote the country as a tourist destination.[34][35] Effective 29 July 2007, betel chewing, along with smoking, has been banned from theShwedagon Pagoda, the country's most important religious site.[36] In 2010, theMinistry of Education's Department of Basic Education and Burma's Anti-Narcotics Task Force collaborated to prohibit betel shops from operating within 50 metres (160 ft) of any school.[37]

  • Betel quid vendor at Bogyoke Market in Yangon, Myanmar
    Betel quid vendor at Bogyoke Market inYangon, Myanmar
  • Betel quid preparation, Myanmar.
    Betel quid preparation, Myanmar.
  • Red betel quid spit on a bridge in Mandalay
    Red betel quid spit on a bridge inMandalay

Nepal

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Paan is chewed mainly byTerai 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 calledmeetha 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.[citation needed]

Pakistan

[edit]

The consumption ofpaan has long been a very popular cultural tradition inPakistan, especially in the port city of Karachi,[38] although the tradition is dying among the younger generation.[39] 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 ofSindh,[40] althoughpaan is also imported in large quantities fromBangladesh andSri Lanka.

The culture of chewingpaan has also spread inPunjab, where apaan shop can be found in almost every street and market. In the famousAnarkali Bazar inLahore a street calledpaan gali is dedicated forpaan and other Pakistani products.[41]

The rate oforal cancer has grown substantially in Pakistan due to chewing ofpaan.[42][43][44]

Philippines

[edit]

Betel nut chewing was formerly widespread in the indigenousethnic 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 theAustronesian expansion (seehistory section).[11][45] The Philippines also has the highest genetic diversity inAreca catechu populations and is home to several closely relatedAreca palm species,[11] including a couple ofendemic species that are used as (inferior) substitutes forAreca catechu, these areAreca caliso (known askaliso orsakolon) andAreca ipot (known asipot orsaksik). Several varieties ofAreca catechu nuts were also known in the Philippines, distinguished chiefly by the shape of the fruits.[46]

Betel nut chewing was described as being a "universal" practice among older people in the early 1900s. The most common configuration of the quid combines areca nut with slaked lime (usually made from heating crushed sea-shells) and betel leaves (tambul orsiri). Tobacco may or may not be added.[46][47][48] In modern times, it has grown out of favor and has been replaced by cigarettes andchewing gum. The practice only survives among more remote ethnic groups like theCordillerans ofLuzon, and theLumad andMoro people ofMindanao.[49]

In the native languages of the Philippines, betel nut chewing is known variously asbuyo,bunga,hitso, orngangà inTagalog,Bikol, and theVisayan languages;dapiau inIvatan; andbua,mama ormaman inIlocano;luyos inKapampangan;pasa inBasilan; andlugos inZamboanga; among other names.[46][49]

Taiwan

[edit]

In Taiwan betel quid is sold from roadside kiosks, often by the so-calledbetelnut beauties although these are becoming fewer and fewer (simplified Chinese:槟榔西施;traditional Chinese:檳榔西施;pinyin:bīnláng xīshī;Pe̍h-ōe-jī:pin-nn̂g se-si) – scantily clad girls selling a quid preparation of betel leaf, betel nuts, tobacco and lime. It is a controversial business, with critics questioning entrapment, exploitation, health, class and culture.[50]

Vietnam

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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.[51]

  • Vietnamese betel nut kit from the Vietnam Museum of Ethnology
    Vietnamese betel nut kit from the Vietnam Museum of Ethnology
  • Betel service kit from the Imperial court of the Nguyễn dynasty (c.19th century)
    Betel service kit from the Imperial court of theNguyễn dynasty (c.19th century)
  • Betel quid vendor
    Betel quid vendor
  • A plate of betel nut
    A plate of betel nut
  • A plate of betel nut in a Vietnamese wedding
    A plate of betel nut in aVietnamese wedding

Health effects

[edit]
Health effects of chewing paan: gum damage, tooth decay and an increased risk of oral cancer

Chewing betel quids and areca nut causes multiple forms of cancer and cardiovascular disease, with or without tobacco.[1][52][53][54]

Betel nut chewing causes an increased risk ofhead and neck cancers andesophageal cancer.[55][56][57] Betel quid affects almost all parts of the human body, including the brain, heart, lungs,gastrointestinal tract and reproductive organs. It can causemyocardial infarction,cardiac arrhythmias,liver damage,asthma,type II diabetes,hyperlipidemia,metabolic syndrome,hypothyroidism,prostate hyperplasia andinfertility.[58]

When chewed with additional tobacco in its preparation (like ingutka), there is an even higher risk for cancer, especially fororal andoropharyngeal cancers.[7] With tobacco it also raises the risk of fatalcoronary artery disease, fatal stroke and non-fatal ischaemic heart disease[8][9]

Women who chew areca nut formulations, such aspaan, during pregnancy significantly increase adverse outcomes for the baby. Betel quid chewing can causestillbirth,premature birth,low birth weight.[59][60][61]

It is estimated that around 600 million people worldwide regularly use this drug preparation.[6] Attempts by theWorld Health Organization to control betel nut chewing remain problematic, as the custom is deeply rooted in many cultures, including possessing religious connotations in some parts of Southeast Asia and India. Despite being associated with adverse health outcomes, this practice is not included in the list of risk factors examined by the Global Burden of Diseases, Injuries, and Risk Factors (GBD).[62]

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.[63]

History

[edit]
See also:Domesticated plants and animals of Austronesia
Areca catechu illustrated byFrancisco Manuel Blanco inFlora de Filipinas (1880–1883). It is originally native to thePhilippines

Based on archaeological, linguistic, and botanical evidence, betel chewing is most strongly associated with theAustronesian peoples. Chewing betel requires the combination of areca nut (Areca catechu) and betel leaf (Piper betle). Both plants are native from the region betweenIsland Southeast Asia toAustralasia.A. catechu is believed to be originally native to thePhilippines, where it has the greatest morphological diversity as well as the most closely relatedendemic species. The origin of the domestication ofPiper betle, however, is unknown, although it is also native to thePhilippines, theLesser Sunda Islands, andIndochina. It is also unknown when or why the two plant products were combined, as areca nut alone can be chewed as a stimulant.[11][45] In easternIndonesia, leaves from otherPiper species are sometimes used in place of betel leaves.[64]

The oldest unequivocal evidence of betel chewing is from the Philippines. Specifically that of several individuals found in a burial pit in theDuyong Cave site ofPalawan island dated to around 4,630±250 BP. The dentition of the skeletons is stained, typical of betel chewers. The grave also includesAnadara shells used as containers of lime, one of which still contained lime. Burial sites inBohol dated to the first millennium CE also show the distinctive reddish stains characteristic of betel chewing. Based on linguistic evidence of how the reconstructedProto-Austronesian term*buaq originally meaning "fruit" came to refer to "areca nut" inProto-Malayo-Polynesian, it is believed that betel chewing originally developed somewhere within the Philippines shortly after the beginning of theAustronesian expansion (~5,000 BP). From the Philippines, it spread back toTaiwan, as well as onwards to the rest ofAustronesia.[11]

There are very old claims of betel chewing dating to at least 13,000BP at theKuk Swamp site inNew Guinea, based on probableAreca sp. recovered. However, it is now known that these might have been due to modern contamination of sample materials. Similar claims have also been made at other older sites withAreca sp. remains, but none can be conclusively identified asA. catechu and their association with betel peppers is tenuous or nonexistent.[11]

A map showing the migration and expansion of theAustronesians (5,500 to 800 BP), which roughly corresponds to the prehistoric distribution of betel chewing

It reachedMicronesia at around 3,500 to 3,000 BP with the Austronesian voyagers, based on both linguistic and archaeological evidence.[65] It was also previously present in theLapita culture, based on archaeological remains fromMussau dated to around 3,600 to 2,500 BP. But it did not reachPolynesia further east. It is believed that it stopped in theSolomon Islands due to the replacement of betel chewing with the tradition ofkava drinking prepared from the relatedPiper methysticum.[66][67] It was also diffused into East Africa via the Austronesian settlement ofMadagascar and theComoros by around the 7th century.[11]

The practice also diffused to the cultures the Austronesians had historical contact with. It reached theDong Son culture via the AustronesianSa Huỳnh culture of Vietnam at around 3,000 to 2,500 BP through trade contacts withBorneo. It is from this period that skeletons with characteristic red-stained teeth start to appear inMainland Southeast Asia. It is assumed that it reached South China andHainan at around the same time, though no archaeological evidence for this can be found as of yet. InCambodia, the earliest evidence of betel nut chewing is from around 2,400 to 2,200 BP. It also spread toThailand at 1,500 BP, based on archaeobotanical evidence.[11]

In the Indian subcontinent, betel chewing was introduced through early contact of Austronesian traders fromSumatra,Java, and theMalay Peninsula with theDravidian-speakers ofSri Lanka and southern India at around 3,500 BP. This also coincides with the introduction of Southeast Asian plants likeSantalum album andCocos nucifera, as well as the adoption of the Austronesianoutrigger ship andcrab-claw sail technologies by Dravidian-speakers. Unequivocal literary references to betel only start appearing after theVedic period, in works likeDipavaṃsa (c.3rd century CE) andMahāvaṃsa (c. 5th century). Betel chewing only reachednorthern India andKashmir after 500 CE through trade withMon-Khmer-speaking peoples in theBay of Bengal. From there it followed theSilk Road toPersia and into theMediterranean.[11][68]

Chinese records, specificallyLinyi Ji byDongfang Shuo associate the growing of areca palms with the first settlers of the AustronesianChampa polities in southern Vietnam at around 2,100 to 1,900 BP. This association is echoed inNanfang Cao Mu Zhuang byJi Han (c. 304CE) 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 Chinesebin lang for "areca nut", with the meaning of "honored guest", reflecting Chamic traditions. The same for the alternate termbin men yao jian, literally meaning "guest [at the door] medicinal sweetmeat".[11]

See also

[edit]

References

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Wikimedia Commons has media related toPaan.
  • Nutritional composition of paan (archived 1 April 2011)
  • IARC Working Group on the Evaluation of Carcinogenic Risks to Humans; International Agency for Research on Cancer (2004).Betel-quid and Areca-nut Chewing and Some Areca-nut-derived Nitrosamines. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 85. p. 2004.ISBN 978-92-832-1285-0.
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