Areca nut (betel nut) chewing: a popular Indian cultural practice and its mucosal implications

Abstract

Areca nut, a seed of the tropical palm, Areca catechu, is grown and chewed in many Asian countries, including India, Pakistan, Bangladesh, Myanmar, Cambodia, Indonesia, the Philippines, and Vietnam. India is documented as the biggest consumer of areca nut. In Hindi, the national language of India, this nut is called ‘‘supari’’. Areca nut (also, wrongly, called ‘‘betel’’ nut) is consumed in many forms. It is consumed in its raw form after being cut into small pieces with a special cutter, either at home or in shops and stalls that sell it (Fig. 1). However, the most popular method of consumption involves wrapping pieces of areca nut in a leaf (betel leaf or ‘‘paan’’) along with catechu (powdered bark of a tree), slaked lime, and other spices and condiments, including saffron, clove, cardamom, and aniseed, with or without tobacco, and then chewing it rather like a quid of tobacco (Fig. 2). The betel leaf is heart-shaped and comes from the vine, Piper betle. Areca nut with or without tobacco can also be chewed as ‘‘gutkha’’ (also known as ‘‘paan malsala’’ or ‘‘mawa’’), a form that has become very popular. It is commercially available as small pieces of areca nut treated with spices and condiments, with or without tobacco, and packed in small polythene sachets (Fig. 3). The cultural practice of paan chewing is documented in Indian mythology and dates back 5000 years to the scripture Shrimad Bhagvatam, one of the oldest of the Hindu scriptures, which describes Lord Krishna as chewing paan. It is believed that Queen Noorjahan of the Mughal dynasty popularized the habit of paan chewing by adding areca nut and smearing it with slaked lime and catechu liquid to impart a red look to the lips and tongue. Paan was also believed to be a mouth freshener and a digestive, a belief that is prevalent even today. The aroma of the ingredients of paan with areca nut can be so overpowering that it can mask the smell of alcohol and other noxious substances. Paan and its ingredients are recognized by Ayurvedic physicians as an antiseptic, an aphrodisiac, a cure for headaches, joint pains, constipation, and congestion, an antihelminthic, and even a lactation agent when used topically. In the past, paan had distinctly sexual associations, partly as a result of its breath freshening properties, and was frequently consumed by courting couples. The areca nut was perceived to represent the male and the betel leaf the female principle. Along with the areca nut, paan is considered auspicious 229 Figure 2 Prepared paan with paan leaves, catechu and lime Figure 1 Areca nut and cutter