High prevalence of betel, tobacco chewing in Western Pacific

WHO News Release

New report reveals high prevalence of betel, tobacco chewing in Western Pacific

MANILA, 23 March 2012 – A new report by the World Health Organization (WHO) reveals a shockingly high prevalence of areca nut (also called betel) and tobacco chewing in the Western Pacific Region and urges governments and other stakeholders to make people aware of the dangers to health.

"Although people understand the harms of smoking and exposure to second-hand smoke, they don’t generally appreciate the dangers of tobacco and betel nut chewing,” says Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “People need to know that chewing tobacco and betel nut are highly dangerous, too, whether taken together or separately.”

The report, “Review of Areca (Betel) Nut and Tobacco Use in the Pacific: a technical report,” says that as many as half of the adults in Palau, Papua New Guinea and the Solomon Islands chew betel nut either alone or with tobacco. It details the origin, history and current trends of betel nut and tobacco use in 10 Western Pacific countries and provides a platform of action for the control of the substances.

The International Agency for Cancer Research classifies betel nut as a Group 1 carcinogen. Smokeless tobacco use is associated with cancers of the oral cavity, pancreas and oesophagus. The nicotine in tobacco also leads to addiction, making it more difficult to give up the betel nut chewing when mixed with tobacco.

"The increasingly common practice of chewing betel nut quid mixed with tobacco greatly increases a person's risk for bleeding gums, periodontal disease and oral lesions and cancer,” says Dr Shin. “Indeed, countries of the Western Pacific where this practice is common have high rates of oral cancer. I’m greatly concerned that this problem may worsen due to the increasing prevalence of betel and tobacco chewing among young people," he adds.

In Palau, 63% of middle school and 75% of high school students have chewed betel nut, and more than half of the high school students have chewed it with tobacco, with the vast majority having used cigarettes as their source of tobacco, according to the Global Youth Tobacco Survey.

Dr Shin stresses the need for governments to fully implement the WHO Framework Convention on Tobacco Control, especially its provisions for raising tobacco taxes, restricting sales to minors, preventing sales of single sticks or loose tobacco, and halting aggressive sales and promotion of tobacco products at the point of sale, along with betel nut.

New research conducted by Loma Linda University in the United States of America and WHO’s Dr Daravuth Yel shows that betel nut quid (areca nut, betel leaf and tobacco) may make users more susceptible to such infectious diseases as HIV, tuberculosis, dengue and typhoid. The study, which analysed results of Cambodia’s national tobacco survey and was published in the International Journal of Infectious Disease, raises the possibility that tobacco control could be an important component in the control of infectious diseases. Compared to people who did not use betel quid, users were 2.6 times more likely to be diagnosed with HIV/AIDS, 2.4 times more likely to have had dengue, 1.5 times more likely be diagnosed with tuberculosis and 1.48 times more likely to have had typhoid.
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