The Asian
Betel quid Consortium (ABC) study in 2011 (comprising of Taiwan, China, Malaysia,
Indonesia, Nepal, and Sri Lanka) found that the prevalence of betel quid and
areca nut chewing in the adult male population varied from 10% in Malaysia to
44% in Nepal; and from 2.3% in mainland China to 47.8% in Indonesia among
women. Surprisingly in Malaysia and Indonesia, the use among women was higher (32%
and 48%, respectively) than for men (10% and 12%).
There is a
great diversity in the way areca nut is consumed in different countries. In most
of the country's areca nut is chewed with betel leaf and lime. Tobacco is an
important adjunct used in Betel quid in several countries. Flavored areca nut
alone is consumed as a mouth freshener in certain countries. There is an
increasing trend in area nut consumption in countries like India, Pakistan,
Bangladesh, Papua New Guinea and also a sharp decline in areca nut consumption
is being witnessed in countries like Thailand and Taiwan.
In general,
the practice of Betel quid (Tambula) chewing among the general public in most of the southeast Asian countries is based on four factors: social acceptability, religious
beliefs, perceived health benefits and addiction. In India, Indonesia,
Thailand, Myanmar and Cambodia, offering ingredients of Tambula (areca nut and
betel leaf) is an integral part of several religious ceremonies. There is a
social acceptability, and it is the normal practice to consume Tambula after the
feasts and in social gatherings.
In India and Pakistan, Gutkha (areca nut mixed with flavoured
tobacco and slaked lime) consumption has become a major addiction. In Taiwan, chewing unripe areca nut with husk of 2-3 months maturity with lime powder and betel vine spike has become an
addiction. In Papua New Guinea, chewing dehusked unripe areca nut of 6-7 months maturity with betel vine spike and lime powder is an addiction.
A summary of
areca nut consumption pattern in the major areca nut consuming countries is
given below.
