Legislator Su says the government should let people decide for themselves what constitutes an acceptable risk. Taiwanese do it, but Westerners don't, so it must be low-class and disreputable. Betel-nut chewers would say just the opposite. Clearly, Taiwan is going through an identity crisis. And the betel nut, in its own modest way, is either part of the solution or part of the problem.
Some users see betel-nut as a benign alternative to tobacco or alcohol.
Not so, say many doctors. In Taiwan, the oral-cancer rate is almost three times as high as in the U.S., and four times higher than that of Japan. Paan, a preparation of betel nut, lime paste, cardamom and turmeric, is chewed often as a post-dinner stimulant or digestive throughout the subcontinent. South Asians, too, have much higher rates of mouth, throat and esophagus cancer than populations that do not consume betel nuts. It may be that a high copper content causes oral cancer, according to British medical journal, The Lancet.