Paan Use Research Articles

A COMPARATIVE STUDY ON ANTI-OXIDATIVE PROPERTIES OF DIFFERENT CULTIVARS OF PIPER BETLE COLLECTED FROM HOWRAH DISTRICT (WEST BENGAL)

The incidences of inammatory diseases are increasing in Asia with maximum incidence in India among the south-east Asian countries. There is a need for development of novel approaches to treat or prevent the diseases using eco-compatible drugs. Paan or Piper betle has been traditionally known as a recreational food. However due to its properties it is a functional food as well. Ayurveda illustrates the use of Paan as a nutraceutical. Paan is known to possess antioxidant, anti-inammatory, anti-apoptotic, anti-cancer and anti-microbial properties. The essential oil (1%–3%) in leaves are used in making ayurvedic medicines and herbal products. Exploration of its anti-oxidative potential may reveal some bioactive or higher phenolic and avonoid compound to enhance its nutritive value and help in combating various inammatory and degenerative diseases. With this aim, we have planned to screen a number of varieties of paan collected from different districts of West Bengal, by a panel of different cell free antioxidative biochemical assays, to compare four different anti-oxidative potentials in four different cultivars of a particular geographical location and in a particular season (summer) of collection from Howrah district of West Bengal. The study revealed the best variety of Howrah district which has the potential to combat the inammatory and degenerative diseases

Total, direct, and indirect effects of paan on oral cancer.

Paan (betel leaf and betel nut quid) used with or without tobacco has been positively associated with oral cancer. Oral submucous fibrosis (OSMF), a precancerous condition caused by paan, lies on the causal pathway between paan use and oral cancer. The purpose of this analysis was to estimate the effect of paan consumption on oral cancer risk when it is mediated by OSMF. We used mediation methods proposed by VanderWeele, which are based on causal inference principles, to characterize the total, direct, and indirect effects of paan, consumed with and without tobacco, on oral cancer mediated by OSMF. We reanalyzed case-control data collected from three hospitals in Karachi, Pakistan, between July 1996 and March 1998. For paan without tobacco, the total effect on oral cancer was OR 7.39, 95% CI 1.01, 38.11, the natural indirect effect (due to OSMF among paan users) was OR 2.48, 95% CI 0.99, 10.44, and the natural direct effect (due to paan with OSMF absent) was OR 3.32, 95% CI 0.68, 10.07. For paan with tobacco, the total direct effect was OR 15.68, 95% CI 3.00, 54.90, the natural indirect effect was OR 2.18, 95% CI 0.82, 5.52, and the natural direct effect was OR 7.27, 95% CI 2.15, 20.43. Paan, whether or not it contained tobacco, raised oral cancer risk irrespective of OSMF. Oral cancer risk was higher among those who used paan with tobacco.

Oral health and the provision of care to panjabi patients in the UK

There is a substantial Panjabi community in the UK and its language is the second most common to be used in the country. As a result, it is critical that all practitioners concerned with oral health are aware of the dental practices of this community and of the increased risk of conditions such as head and neck cancer. This review assesses work published in the UK as well as in India and Pakistan. It emphasizes the need for a better understanding of cultural aspects of our care. Of course many aspects are not unique to this community but a better understanding will help with approaches to other communities. Social practices, such as paan use, can occur with greater frequencies amongst others, such as the Bangladeshi community. However, the purpose of this review is to concentrate attention on the largest minority community in the UK and, through this mechanism, to encourage interest in other groups. This interest should lead to practical approaches, such as: the development of relevant focus groups to improve clinical care; to develop outreach programmes to schools and community associations, including temples, gurdwaras and mosques; the production of appropriate literature and other media. Clinical Relevance: This review should ensure that the reader is aware of attitudes towards dental care in the Panjabi community and of the increased frequency of a range of clinical conditions.

Disengagement beliefs in South Asian immigrant smokeless tobacco users: A qualitative study

Gutka and tambaku paan (smokeless tobacco products used by South Asian immigrants) are carcinogenic to humans (and perceived as such), yet, one-fourth of South Asian immigrants report current use. This study examined disengagement beliefs that perpetuate gutka/tambaku paan use among South Asians despite awareness of health risks. Six focus groups were conducted with immigrant South Asian adult gutka/tambaku paan users, in Gujarati, Bengali and Urdu languages in New York, USA. Participants included 39 South Asian adults residing in the New York City Metropolitan area, current (a minimum of weekly gutka or tambaku paan use in the last 12 months) or former (regular use prior to past 12 months) gutka or tambaku paan users and self-reported spoken fluency in Gujarati, Urdu or Bengali languages. Participants identified many health risks associated with gutka/tambaku paan use including locked jaw, high blood pressure and cancer. Five themes of disengagement beliefs emerged: (a) skepticism about the gutka/tambaku paan–cancer link, (b) perceived invulnerability to harm, (c) compensatory beliefs, (d) faith-based rationalization and (e) acknowledgment of addiction. To promote smokeless tobacco cessation among South Asians, interventions to counter disengagement beliefs and heighten the discomfort between the dissonant cognitions represent a promising area warranting further attention.

The impact of a community-based health education programme on oral cancer risk factor awareness among a Gujarati community

To determine any differences in oral cancer risk factor awareness and behaviour among first and second generation Gujarati muslims and to investigate the impact of a community-based health education programme on oral cancer risk factor awareness. Respondents completed a confidential, bilingual questionnaire in English and Gujarati regarding alcohol, tobacco, paan, sopari, paan masala and gutka use before and after a community-based health education programme on oral cancer risk factors. Community Health Fair. Indian Muslim Welfare Association, Batley, West Yorkshire. Ninety-six male and female Gujarati muslims aged 16 to 81 years. Quantitative results on oral cancer risk factor awareness before and after a health education programme. Quantitative figures obtained from the questionnaire with regards to alcohol, tobacco, paan, sopari, paan masala and gutka usage. There were very low levels of alcohol consumption among Gujarati muslims. First generation Gujarati males consumed significantly more tobacco than second generation Gujarati males, difference in proportion 0.30 (0.03 to 0.56, p = 0.03). There was complete absence of paan use among Gujarati females. First generation Gujarati males consumed significantly higher amounts of sopari compared with their male counterparts in the second generation (p = 0.003). There were very low rates of paan masala use. Only first generation Gujarati males consumed gutka. Significantly more first generation males and females correctly identified all oral cancer risk factors after the health education intervention compared with baseline (difference 0.40, 95% CI 0.23 to 0.57, p = <0.001). Significantly more second generation males and females correctly identified all oral cancer risk factors after the health education intervention compared with baseline (difference 0.45, 95% CI 0.28 to 0.61, p = <0.001). Our study demonstrated significant differences in oral cancer risk factor awareness and practices among first and second generation Gujarati muslims and that a local community-based health education programme was effective in raising awareness.

Gutka and Tambaku Paan Use Among South Asian Immigrants: A Focus Group Study

Smokeless tobacco use is prevalent among South Asian immigrants, particularly in the forms of gutka and tambaku paan. In this paper, we examined (a) gutka and tambaku paan initiation and use patterns among South Asian immigrants, and (b) perceptions related to quitting and tobacco control. Six focus groups were conducted with 39 South Asian adult gutka/tambaku paan users, in three different South Asian languages (Gujarati, Bengali, and Urdu). Participants reported easy availability of gutka and tambaku paan in neighborhood stores, and noted several factors that promoted initiation (including social networks, perceived benefits, and curiosity). Due to awareness of low social acceptance of gutka and tambaku paan in the US, some participants discussed changing patterns of use following immigration. Finally, participants proposed roles of various agencies (e.g., doctors'/dentists' role, government-led initiatives) for tobacco control in South Asian immigrant communities. This research provides implications for improving tobacco control efforts in the United States, particularly for South Asian immigrants.

Associated Factors of Paan Use in Southeast Iran

Background: Smokeless tobacco use is growing among youth in many countries especially developing countries. Paan is one of these products that its use in many cultures is of interest. This study evaluates the use of paan among males school-age and assess the attributed factors. Methods: A cross-section al study was done on 504 high school pupils of Zahedan city, Capital of Sistan va Baluchistan Province, southeastern Iran in June 2007. Samples were selected by multistage sampling method from high school students in different geographic areas. A questionnaire including 43 questions was completed through interviews. Results: The mean age of participants was 16.2±1.1 years. While 10.4% of the students were current users of paan, 17.9% were ex-users. Mean duration of using paan was 2.5±1.6 years. Number of daily paan consumption was 4.2±3.6/day. Cigar was the most common substance used at least once by pupils (18.6%) followed by paan (17.9%), naas (11.5%) and other illicit drugs. Only 64.7% of our pupils did not use any illicit drug at the time of study. Risk of paan use among students who had a history of taking any other substance was 18-fold more than others. In the case of each attitude, score accretion and risk of paan consumption declined up to 16%. Conclusion: Among multiple personal, familial and environmental factors, positive history of using any kind of illicit drugs by students and their attitude had strong association with paan use.

Paan and Gutka Use in the United States

Smokeless tobacco and areca nut are popular with South Asians and South Asian immigrants, most commonly used as paan and gutka. Their regular use leads to oral cancer. The South Asian community in the U.S. is rapidly growing, where paan and gutka are readily available. The study was the first exploration of the migration of the paan and gutka habits, and their use in the U.S. A 108-item questionnaire on paan and gutka usage and beliefs was administered to 138 first-generation Bangladeshi and Indian-Gujarati immigrant adults at community sites in the New York metropolitan area. Forty-five percent Indian-Gujaratis reported ever-regular paan use; of which 5% are current users. Thirty-one percent reported ever-regular gutka use; of which 77% are current users. Thirty-five percent Bangladeshis reported ever-regular paan use; of which 70% are current users. Nine percent reported ever-regular gutka use; of which 67% are current users. Bangladeshis are more likely to identify paan as causing oral cancer. Indian-Gujaratis are more likely to identify gutka as causing oral cancer. Between the two communities, there were significant differences in paan and gutka usage, migration effects, and oral cancer risk perception. There is a need for comprehensive migration studies on the determinants of usage, and for community-specific interventions for these carcinogenic products.

Socio-demographic correlates of betel, areca and smokeless tobacco use as a high risk behavior for head and neck cancers in a squatter settlement of Karachi, Pakistan.

BackgroundHead and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of any of the above products.ResultsDaily use of all the substances except chaalia was higher among males compared to females. Chaalia use was higher among adolescents than adults while non-married consumed both chaalia and gutka more than married. Mohajir ethnicity had higher prevalence of paan, gutka and tumbaku use while Pathans had higher prevalence of niswar use.ConclusionPrevalence of use of chewable products is high in Pakistan with particularly high use of certain substances related with socio-demographic profiles. Industrially prepared products, chaalia and gutka, are gaining popularity among youth. Policies and focused interventions can be developed taking into consideration the preferred use of products among different socio-demographic groups.

Illicit and traditional drug use among ethnic minority adolescents in East London

To explore ethnic variations in the use of illicit and traditional drugs, and the association of indicators of acculturation with drug use among an ethnically diverse representative sample of early adolescents in East London. A cross-sectional questionnaire survey. Confidential questionnaires were used to assess 2789 male and female pupils in years 7 and 9, aged 11-14 years old, from a representative sample of 28 secondary schools in East London. In total, 10.8% reported having ever tried illicit drugs and 7.3% reported ever using cannabis. Compared with white British adolescents, cannabis use in the previous month was significantly higher amongst black Caribbean adolescents. Lifetime cannabis use was significantly higher amongst black Caribbean and mixed ethnicity young people, but was lower amongst Bangladeshi, Indian and Pakistani adolescents. Living in UK for 5 years or less markedly reduced the risk of lifetime and recent cannabis use when controlled for ethnicity and social class. Glue or solvent use was reported in 3.2% of adolescents, with use significantly higher amongst Bangladeshi young people. Lifetime paan use was reported by 14.1% of the sample, and was almost completely confined to South Asian or mixed ethnicities. Ethnic differences in illicit drug use were found in the study population, and significant differences were found between ethnic groups often identified as 'black.' Further research is needed in understanding cultural-specific risk and protective factors in different ethnic groups, and the importance of cultural identity in mediating health risk behaviors. The high use of paan and glue/gas/solvents by Bangladeshi young people poses an unappreciated public health problem that may require targeted interventions.

Alcohol, tobacco and paan use and understanding of oral cancer risk among Asian males in Leicester

Alcohol, tobacco and paan use and understanding of oral cancer risk among Asian males in Leicester

Dental service use and the implications for oral cancer screening in a sample of Bangladeshi adult medical care users living in Tower Hamlets, UK.

To assess the use of dental services, barriers to uptake of dental care and attitudes to regular dental examinations and the prevalence of tobacco and paan chewing habits in a group of Bangladeshi medical care users. Multi-centre cross-sectional study. Four general medical practices' waiting areas in Tower Hamlets. Bangladeshi adults aged 40 years and over. An interview schedule. The prevalence of tobacco smoking and paan chewing with or without the addition of tobacco. The use of dental services, barriers to the use of dental services and attitudes to regular dental examinations. Results were obtained from 158 subjects (response rate 85%). 25% of the whole sample had never visited a dentist. These were significantly (P < 0.05) more likely to be women, who also thought regular check-ups were of little value. In their use of health services 73% experienced language difficulties. 33% of the sample were tobacco smokers. Paan was chewed by 78% of the sample with significantly (P < 0.05) more females than males adding tobacco to their quid and chewing more frequently than males. There are considerable barriers to be overcome if dental practices are to be the site for oral cancer screening and oral health promotion in this population. There are sex differences in reported behaviour and attitudes about use of dental services and in tobacco and paan use in this Bangladeshi sample. Further research is needed to establish why this ethnic minority attend general medical practices but not general dental practices.

Dental services for the Bangladeshi community

Aim To assess the use of dental services, barriers to uptake of dental care and attitudes to regular dental examinations and the prevalence of tobacco and paan chewing habits in a group of Bangladeshi medical care users. Design Multi-centre cross-sectional study. Setting Four general medical practices' waiting areas in Tower Hamlets. Subjects Bangladeshi adults aged 40 years and over. Intervention An interview schedule. Main outcome measures The prevalence of tobacco smoking and paan chewing with or without the addition of tobacco. The use of dental services, barriers to the use of dental services and attitudes to regular dental examinations. Results Results were obtained from 158 subjects (response rate 85%). 25% of the whole sample had never visited a dentist. These were significantly (P < 0.05) more likely to be women, who also thought regular check-ups were of little value. In their use of health services 73% experienced language difficulties. 33% of the sample were tobacco smokers. Paan was chewed by 78% of the sample with significantly (P < 0.05) more females than males adding tobacco to their quid and chewing more frequently than males. Conclusion There are considerable barriers to be overcome if dental practices are to be the site for oral cancer screening and oral health promotion in this population. There are sex differences in reported behaviour and attitudes about use of dental services and in tobacco and paan use in this Bangladeshi sample. Further research is needed to establish why this ethnic minority attend general medical practices but not general dental practices.

Cannabis and schizophrenia — A follow-up

To explore ethnic variations in the use of illicit and traditional drugs, and the association of indicators of acculturation with drug use among an ethnically diverse representative sample of early adolescents in East London.A cross-sectional questionnaire survey.Confidential questionnaires were used to assess 2789 male and female pupils in years 7 and 9, aged 11–14 years old, from a representative sample of 28 secondary schools in East London.In total, 10.8% reported having ever tried illicit drugs and 7.3% reported ever using cannabis. Compared with white British adolescents, cannabis use in the previous month was significantly higher amongst black Caribbean adolescents. Lifetime cannabis use was significantly higher amongst black Caribbean and mixed ethnicity young people, but was lower amongst Bangladeshi, Indian and Pakistani adolescents. Living in UK for 5 years or less markedly reduced the risk of lifetime and recent cannabis use when controlled for ethnicity and social class. Glue or solvent use was reported in 3.2% of adolescents, with use significantly higher amongst Bangladeshi young people. Lifetime paan use was reported by 14.1% of the sample, and was almost completely confined to South Asian or mixed ethnicities.Ethnic differences in illicit drug use were found in the study population, and significant differences were found between ethnic groups often identified as ‘black.’ Further research is needed in understanding cultural-specific risk and protective factors in different ethnic groups, and the importance of cultural identity in mediating health risk behaviors. The high use of paan and glue/gas/solvents by Bangladeshi young people poses an unappreciated public health problem that may require targeted interventions.