Betel (Piper betle) is a tropical shade-loving perennial evergreen vine. It is best known as a component of "betel nut" or "betel quid". Betel quid consists of slices of "areca nut" (usually the seed of the palm Areca catechu) wrapped in betel leaf, often with other components such as slaked lime (calcium hydroxide paste) and tobacco or spices for flavoring.
Chewing betel quid is addictive and is reportedly done daily by as many as 200 to 600 million people globally across the Indian subcontinent and through China, Southeast Asia, and the Pacific--and immigrants to other parts of the world often continue to chew betel quid in their adopted countries. Among different populations, users may be demographically quite different, e.g., largely women in Cambodia, but mainly men among aboriginal Taiwanese. At least in the Western Pacific Region, there is evidence that the frequency of betel quid use is increasing and that this use is increasingly associated with the chewing of tobacco.
Although chewing betel quid is encouraged by some traditional medicine practitioners, there is much scientific evidence of diverse and substantial harm to the user's health resulting from this practice, including the induction of oral precancerous lesions that have a high propensity to progress, periodontal disease, and a range of systemic problems. As these negative health impacts have become clearer, this has elevated concern among public health experts, including those at the World Health Organization and the U.S. Centers for Disease Control.
Betel is typically propagated asexually from stem cuttings rather than from seeds.The leaves of other Piper species are sometimes substituted in betel chewing, but P. betle is the only one that has been domesticated specifically for chewing. Primarily in the Moluccas and Papua New Guinea, the young inflorescences of P. betle are reportedly preferred to the leaves.
- Gupta, P.C. and C.S. Ray. 2004. Epidemiology of betel quid usage.Annals of the Academy of Medicine Singapore 33(Suppl): 31S-36S.
- Lin, C.-F., J.-D. Wang, P.-H. Chen, S.-J. Chang, Y.-H. Yang, and Y.-C. Ko. 2006. Predictors of betel quid chewing behavior and cessation patterns in Taiwan aborigines. BMC Public Health 6: 271.
- Zumbroich, T.J. 2008. The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond. eJournal of Indian Medicine Volume 1 (2007–2008): 87–140.
- Al-Rmalli, S.W., R.O. Jenkins, and P.I. Haris. 2011. Betel quid chewing elevates human exposure to arsenic, cadmium and lead. Journal of Hazardous Materials. 190: 69-74.
- Blank, M., L. Deshpande, and R.L. Balster. 2008. Availability and characteristics of betel products i the U.S. Journal of Psychoactive Drugs 40(3): 309-313.
- Singh, P.N., Z. Natto, D. Yel, J. Job, and S. Knutsen. 2012. Betel quid use in relation to infectious disease outcomes in Cambodia. International Journal of Infectious Diseases 16: e262-e267.
- World Health Organization. 2012. Review of Areca (Betel) Nut and Tobacco Use in the Pacific: A Technical Report. PDF available at http://www.wpro.who.int/tobacco/documents/201203_Betelnut/en/index.html.
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