According to WHO Chewing Betel Nut With or Without Tobacco can Cause Cancer: Urgent Need for Public Health Guidance
Chewing areca nut (betel nut) is the fourth most common addiction worldwide after tobacco, alcohol and caffeine. It is consumed by nearly a tenth of the world’s population especially in some Asian countries. It is also consumed by South Asian ethnic groups in the UK. Betel nut is often chewed with piper betel leaves, slaked lime and tobacco – this mixture is called the ‘betel quid’. The International Agency for Research on Cancer (IARC), part of the World Health Organization (WHO), concluded that areca nut is carcinogenic to humans. Professor Parvez Haris and his team at De Montfort University have been investigating the habit of chewing betel nut in the South Asian community, especially the Bangladeshi community. A study led by him revealed that 24% of UK Bangladeshis, sampled in his study, reported chewing betel nut and his research has shown that betel quid’s can be a source of high exposure to toxic chemicals such as arsenic, cadmium and lead. Other researchers have shown that betel nuts are often contaminated with fungi that produce cancer causing aflatoxin.
Bangladeshi women in the UK have the highest prevalence of oesophageal cancer compared to women from other ethnic groups. This is most likely due to betel quid chewing since alcohol consumption in Bangladeshi women is rare. Whilst there is health guidance, health warnings and regulations related to tobacco and alcohol, no such policy exists for betel nut in many countries. In the UK, and in many other countries, sale of betel nut is not restricted and even children can purchase betel nut from shops facilitating the transmission of the habit from one generation to the next. This is of concern since betel nut is classed as a carcinogenic substance by the WHO and it has been linked to many other adverse health effects including diabetes and cardiovascular disease. Indeed, Australia, New Zealand and Canada have banned the sale of betel nut to protect the health of the public.
The Food and Drug Administration (FDA) in the USA lists areca nut on its Poisonous Plants Database. Some in the UK Bangladeshi community, especially women as they have a have higher consumption of betel nut, may be dying from oesophageal cancer caused by this carcinogenic nut. At the very least, awareness needs to be raised about the cancer inducing effects of betel nuts, consumed with or without tobacco. Both women and men from the Bangladeshi community had the highest mortality for COVID-19 in the UK. The cause for the latter is likely to be multifactorial. Considering the well-established harmful effects of betel nut chewing on different health parameters, its role in COVID-19 mortality needs to be investigated.
In this presentation by Professor Parvez Haris, and his PhD student Ms Kshama Rahul Joshi, the case for greater targeted awareness regarding the dangers of chewing betel nut and the need for health warnings and regulations will be discussed.
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