Betel nut chewing

Betel nut chewing, also calledbetel quid chewingorareca nut chewing, is a practice in whichareca nuts(also called "betel nuts") are chewed together withslaked limeandbetel leavesfor theirstimulantandnarcoticeffects, the primary psychoactive compound beingarecoline. The practice is widespread in Southeast Asia,Micronesia,Island Melanesia, and South Asia. It is also found among bothHan Chineseimmigrants and indigenous peoples ofTaiwan,Madagascar, and parts of southern China. It was introduced to theCaribbeanin colonial times.
The preparation combining the areca nut,slaked lime, and betel (Piper betle) leaves is known as abetel quid(also calledpaanorpanin South Asia), but the exact composition of the mixture varies geographically.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 leavescan be excluded. In West Papua, the leaf may be replaced with stem and inflorescence of thePiper betleplant.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.
Betel nut chewing is addictive and causes adverse health effects, mainlyoralandesophageal cancers, and cardiovascular disease.When chewed with additional tobacco in its preparation (like ingutka), there is an even higher risk, especially for oral andoropharyngeal cancers.With tobacco it also raises the risk of fatalcoronary artery disease, fatal stroke,and adverse reproductive effects includingstillbirth,premature birthandlow birth weight.
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 Cavesite of thePhilippines, an area whereareca palmswere native, dated to around 4,630±250BP. Its diffusion is closely tied to theNeolithicexpansion of theAustronesian peoples. It was spread to the Indo-Pacific during prehistoric times, reachingMicronesiaat 3,500 to 3,000 BP,Near Oceaniaat 3,400 to 3,000 BP;South IndiaandSri Lankaby 3,500 BP;Mainland Southeast Asiaby 3,000 to 2,500 BP;Northern Indiaby 1500 BP; andMadagascarby 600 BP. From India it spread westwards toPersiaand 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.
One of the earliest firsthand accounts of betel nut chewing by western authors was fromIbn Battuta. He describes this practice as follows:
An early European description of betel chewing is from theMagellan Expeditionto thePhilippinesin 1521.Antonio Pigafettadescribes the practice of betel nut chewing among the natives of theRajahnate of Butuan.
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.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 sirihset is featured on the 1989–2012 series Malaysian 20-sen coin.
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 Singaporeandsmoking 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.
According to traditionalAyurvedic medicine, chewing betel leaf is a remedy against bad breath (halitosis).
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.
InBangladesh,paanis 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.
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 thezamindariage, 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 theKhasitribe is famous for its special quality. Paan is also used inHindupujaand wedding festivals and to visit relatives. It has become a ritual, tradition and culture of Bangladeshi society. Adult women gather with paandanialong 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.
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.
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.
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.
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 pattais produced mainly in district of Dinajpur, Malda, Jalpaiguri, and Nadia.Mitha pattais produced in places such as Midnapur and South 24 Parganas.
The skilled paan maker is known as apaanwalain North India. In other parts,paanwalasare also known aspanwarisorpanwadis. 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 Deshpandewrote a comic story on the subject ofpaanwala(paan vendor) and performed a televised reading session onDoordarshanduring the 1980s in his unique style.
Paan is losing its appeal to farmers because of falling demand. Consumers prefer chewing tobacco formulations such asgutkaover paan. Higher costs,water scarcityand 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.
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-tamulon axorai, place it in front of theelderand bow to show respect.
Guests may be invited to a wedding reception by offering a few areca nuts with betel leaves. DuringBihu, thehusoriplayers are offered areca nuts and betel leaves by each household while their blessings are solicited.
Paan-tamulis 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.
BanarasiPanofBanaras (Varanasi)is widely famous among Indians and tourists visiting India.
Bersirih,nyirih, ormenginangis a historicalMalayonesiantradition of chewing materials such asnut,betel,gambier, tobacco,clove, andlimestone.
In theMalay Archipelago, themenginangor 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 pinangequipment 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).
TheSirih Pinanghas become a symbol ofMalayculture,with the Malayoral traditionhaving phrases such as "The betel opens the door to the home" or "the betel opens the door to the heart".
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 peopleof theMariana Islandsprefer 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, andvodkaare also sometimes added.
Areca palms have been grown traditionally inGuam,Palau, andYapsince ancient times. It spread toChuukin 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.
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.
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 speciallacquerwarebox for betel quid, calledkun-it(ကွမ်းအစ်), which would be offered to any visitor together withcherootsto smoke andgreen teato 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,aniseseed and a nut cutter.
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.
TaungooinLower Burmais where the best areca palms are grown indicated by the popular expression "like a betel lover taken to Taungoo".Other parts of the country contribute to the best betel quid according to another saying "Tada-Ufor the leaves, Ngamyagyi for the tobacco, Taungoo for the nuts,Sagaingfor the slaked lime,Pyayfor 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 calledkundaungand 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.An aggregate study of cancer registries (2002 to 2007) at theYangonandMandalay General Hospitals, the largest hospitals in the country, found thatoral cancerwas the 6th most common cancer among males, and 10th among females.Of these oral carcinoma patients, 36% were regular betel quid chewers.University of Dental Medicine, Yangonrecords 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.In April 1995, theYangon City Development Committeebanned betel inYangon(Rangoon), in anticipation of Visit Myanmar Year 1996, a massive effort to promote the country as a tourist destination.Effective 29 July 2007, betel chewing, along with smoking, has been banned from theShwedagon Pagoda, the country's most important religious site.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.
Paan is chewed mainly byTeraipeople, 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 paanis 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.
The consumption ofpaanhas long been a very popular cultural tradition inPakistan, especially in the port city of Karachi,although the tradition is dying among the younger generation.In general, though,paanis 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,althoughpaanis also imported in large quantities fromBangladeshandSri Lanka.
The culture of chewingpaanhas also spread inPunjab, where apaanshop can be found in almost every street and market. In the famousAnarkali BazarinLahorea street calledpaan galiis dedicated forpaanand other Pakistani products.
The rate oforal cancerhas grown substantially in Pakistan due to chewing ofpaan.
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).The Philippines also has the highest genetic diversity inAreca catechupopulations and is home to several closely relatedArecapalm species,including a couple ofendemic speciesthat are used as (inferior) substitutes forAreca catechu, these areAreca caliso(known askalisoorsakolon) andAreca ipot(known asipotorsaksik). Several varieties ofAreca catechunuts were also known in the Philippines, distinguished chiefly by the shape of the fruits.
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 (tambulorsiri). Tobacco may or may not be added.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 theCordilleransofLuzon, and theLumadandMoro peopleofMindanao.
In the native languages of the Philippines, betel nut chewing is known variously asbuyo,bunga,hitso, orngangàinTagalog,Bikol, and theVisayan languages;dapiauinIvatan; andbua,mamaormamaninIlocano;luyosinKapampangan;pasainBasilan; andlugosinZamboanga; among other names.
In Taiwan betel quid is sold from roadside kiosks, often by the so-calledbetelnut beautiesalthough 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.
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.
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 ofhead and neck cancersandesophageal cancer.Betel quid affects almost all parts of the human body, including the brain, heart, lungs,gastrointestinal tractand reproductive organs. It can causemyocardial infarction,cardiac arrhythmias,liver damage,asthma,type II diabetes,hyperlipidemia,metabolic syndrome,hypothyroidism,prostate hyperplasiaandinfertility.
When chewed with additional tobacco in its preparation (like ingutka), there is an even higher risk for cancer, especially fororalandoropharyngeal cancers.With tobacco it also raises the risk of fatalcoronary artery disease, fatal stroke and non-fatal ischaemic heart disease
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.
It is estimated that around 600 million people worldwide regularly use this drug preparation.Attempts by theWorld Health Organizationto 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).
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.
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 AsiatoAustralasia.A. catechuis believed to be originally native to thePhilippines, where it has the greatest morphological diversity as well as the most closely relatedendemicspecies. 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.In easternIndonesia, leaves from otherPiperspecies are sometimes used in place of betel leaves.
The oldest unequivocal evidence of betel chewing is from the Philippines. Specifically that of several individuals found in a burial pit in theDuyong Cavesite ofPalawanisland dated to around 4,630±250 BP. The dentition of the skeletons is stained, typical of betel chewers. The grave also includesAnadarashells used as containers of lime, one of which still contained lime. Burial sites inBoholdated to the first millennium CE also show the distinctive reddish stains characteristic of betel chewing. Based on linguistic evidence of how the reconstructedProto-Austronesianterm*buaqoriginally 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.
There are very old claims of betel chewing dating to at least 13,000BPat theKuk Swampsite inNew Guinea, based on probableArecasp. 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 withArecasp. remains, but none can be conclusively identified asA. catechuand their association with betel peppers is tenuous or nonexistent.
It reachedMicronesiaat around 3,500 to 3,000 BP with the Austronesian voyagers, based on both linguistic and archaeological evidence.It was also previously present in theLapita culture, based on archaeological remains fromMussaudated to around 3,600 to 2,500 BP. But it did not reachPolynesiafurther east. It is believed that it stopped in theSolomon Islandsdue to the replacement of betel chewing with the tradition ofkavadrinking prepared from the relatedPiper methysticum.It was also diffused into East Africa via the Austronesian settlement ofMadagascarand theComorosby around the 7th century.
The practice also diffused to the cultures the Austronesians had historical contact with. It reached theDong Son culturevia the AustronesianSa Huỳnh cultureof 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 andHainanat 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 toThailandat 1,500 BP, based on archaeobotanical evidence.
In the Indian subcontinent, betel chewing was introduced through early contact of Austronesian traders fromSumatra,Java, and theMalay Peninsulawith theDravidian-speakersofSri Lankaand southern India at around 3,500 BP. This also coincides with the introduction of Southeast Asian plants likeSantalum albumandCocos nucifera, as well as the adoption of the Austronesianoutrigger shipandcrab-claw sailtechnologies 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 IndiaandKashmirafter 500 CE through trade withMon-Khmer-speaking peoples in theBay of Bengal. From there it followed theSilk RoadtoPersiaand into theMediterranean.
Chinese records, specificallyLinyi JibyDongfang Shuoassociate the growing of areca palms with the first settlers of the AustronesianChampapolities in southern Vietnam at around 2,100 to 1,900 BP. This association is echoed inNanfang Cao Mu ZhuangbyJi 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*pinaŋresulting in Chinesebin langfor "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".