Betel nut chewing
Betel nut chewing, also called betel quid chewing or areca nut chewing, is a practice in which
The preparation combining the areca nut, slaked lime, and betel (Piper betle) leaves is known as a betel quid (also called paan or pan in South Asia), but the exact composition of the mixture varies geographically.
The practice of betel nut chewing originates from Southeast Asia where the plant ingredients are native. The oldest evidence of betel nut chewing is found in a burial pit in the
Betel nut chewing is addictive and has been linked with adverse health effects, mainly oral and esophageal cancers, which occur both with and without tobacco in the mixture.[6][1] Attempts by the World Health Organization to control betel nut chewing remain problematic, as the custom is deeply rooted in many cultures, including possessing religious connotations in some parts of Southeast Asia and India. Despite being associated with adverse health outcomes, this practice is not included in the list of risk factors examined by the Global Burden of Diseases, Injuries, and Risk Factors (GBD).[8] It is estimated that around 600 million people worldwide regularly use this drug preparation.[6]
History
Based on archaeological, linguistic, and botanical evidence, betel chewing is most strongly associated with the
The oldest unequivocal evidence of betel chewing is from the Philippines. Specifically that of several individuals found in a burial pit in the
There are very old claims of betel chewing dating to at least 13,000 BP at the Kuk Swamp site in New Guinea, based on probable Areca sp. recovered. However, it is now known that these might have been due to modern contamination of sample materials. Similar claims have also been made at other older sites with Areca sp. remains, but none can be conclusively identified as A. catechu and their association with betel peppers is tenuous or nonexistent.[7]
It reached
The practice also diffused to the cultures the Austronesians had historical contact with. It reached the Dong Son culture via the Austronesian Sa Huỳnh culture of Vietnam at around 3,000 to 2,500 BP through trade contacts with Borneo. It is from this period that skeletons with characteristic red-stained teeth start to appear in Mainland Southeast Asia. It is assumed that it reached South China and Hainan at around the same time, though no archaeological evidence for this can be found as of yet. In Cambodia, the earliest evidence of betel nut chewing is from around 2,400 to 2,200 BP. It also spread to Thailand at 1,500 BP, based on archaeobotanical evidence.[7]
In the Indian subcontinent, betel chewing was introduced through early contact of Austronesian traders from
Chinese records, specifically Linyi Ji by
Culture
One of the earliest firsthand accounts of betel nut chewing by western authors was from Ibn Battuta. He describes this practice as follows:[citation needed]
The betel is a tree which is cultivated in the same manner as the grape-vine; ... The betel has no fruit and is grown only for the sake of its leaves ... The manner of its use is that before eating it one takes areca nut; this is like a nutmeg but is broken up until it is reduced to small pellets, and one places these in his mouth and chews them. Then he takes the leaves of betel, puts a little chalk on them, and masticates them along with the betel.
An early European description of betel chewing is from the
Those people are constantly chewing a fruit which they call "areca", and which resembles a pear. They cut that fruit into four parts, and then wrap it in the leaves of their tree [sic] which they call "betre". Those leaves resemble the leaves of the mulberry. They mix it with a little lime, and when they have chewed it thoroughly, they spit it out. It makes the mouth exceedingly red. All the people in those parts of the world use it, for it is very cooling to the heart, and if they ceased to use it they would die.
— Antonio Pigafetta, Relazione del primo viaggio intorno al mondo (1521)
Betel quid chewing constitutes an important and popular cultural activity in many Asian and Oceanic countries, including Bangladesh, Myanmar, Cambodia, the Solomon Islands, Thailand, the Philippines, Laos, and Vietnam.[16] Chewing betel was once common in Malaysia, but the practice has long since died out. Betel nut kits (tepak sirih) made of silver and other precious metals, once featured in royal regalia and presented as wedding gifts, have become collectors' items, and a tepak sirih set is featured on the 1989–2012 series Malaysian 20-sen coin.[17]
In urban areas, chewing betel quid is generally considered a nuisance because some chewers spit the betel quid juice out in public areas – compare
According to traditional
Cambodia, Laos and Thailand
The chewing of the product is part of the culture of Cambodia, Laos and Thailand. Cultivation of areca nut palm and betel leaves is common in rural areas of these countries, being a traditional cash crop, and the utensils used for preparation are often treasured. Now, many young people have given up the habit, especially in urban areas, but many, especially older people, still keep to the tradition.[citation needed]
Bangladesh
In Bangladesh, paan is chewed throughout the country by all classes and is an important element of Bangladeshi culture. It is the Bengali 'chewing gum', and usually for chewing, a few slices of the betel nut are wrapped in a betel leaf, almost always with sliced areca nuts and often with calcium hydroxide (slaked lime), and may include cinnamon, clove, cardamom, catechu (khoyer), grated coconut and other spices for extra flavouring. As it is chewed, the peppery taste is savoured, along with the warm feeling and alertness it gives, similar to drinking a fresh cup of coffee.
Paan-shupari (shupari being Bengali for areca nut) is a veritable Bangladeshi archetypal imagery, employed in wide-ranging contexts. Prior to British rule, it was chewed without tobacco, and it is still rarely chewed with tobacco. Betel leaves are arranged aesthetically on a decorated plate called
In Bangladesh paan is traditionally chewed not only as a habit but also as an item of rituals, etiquette and manners. On formal occasions offering paan symbolized the time for departure. In festivals and dinners, in pujas and punyas paan is an indispensable item. Hindus make use of paans as offerings in worship.
Dhakai Khilipan, a ready pack of betel leaf processed in Dhaka is famous in the sub-continent. Old Dhakaites have a rich heritage of creating the best khili paan with many complexes, colourful, aromatic and flavorful ingredients. Although 'paan' has been a staple Bengali custom for ages, a number of high-end stores with premium quality paan has become available in recent times. Paan Supari is perhaps the first such brand, which offers a wide range of khili paan. They also offer a khili paan for diabetic patients called the "paan afsana".
The sweet paan of the
Total cultivated area under the crop in Bangladesh is about 14,175 ha and the total annual production is about 72,500 tons. The average yield per acre is 2.27 tons. There are usually three crops during the twelve months, and they are locally called by the name of the respective months in which they are harvested. Paan leaf is usually plucked in Kartik, Phalgun and Ashad. The Kartik paan is considered by consumers to be the best and Ashad paan the worst. When plucking, it is a rule to leave at least sixteen leaves on the vine.[20]
Different varieties of betel leaf are grown, and the quality differs in shape, bleaching quality, softness, pungency and aroma of leaf. Tamakh paan, a betel leaf blended with tobacco and spices. Supari paan, another variety of white leaf, Mitha paan, a sweet variety, and Sanchi paan are common varieties of betel leaves. Almost every paan-producing district has its own special variety of betel leaf of which consumers are well acquainted. In the past, the best quality of elegant camphor-scented betel leaf named Kafuri paan was produced in the Sonargaon area of Narayangonj district. It was exported to Calcutta and Middle Eastern countries.[20]
The next best is the Sanchi paan grown in Chittagong hill tracts. This variety is not very popular among Bangali people. It is exported to Pakistan for the consumers of Karachi. The commoner varieties are called Desi, Bangla, Bhatial, Dhaldoga, Ghas paan. Bangla paan, is also known as Mitha paan, Jhal paan or paan of Rajshahi. At present, this variety is becoming extinct, due to emergence of more profitable and lucrative fast-growing varieties of paan crops. Normally, betel leaves are consumed with chun, seed cinnamon, cardamoms and other flavored elements.[20]
China
India
In a 16th-century cookbook, Nimatnama-i Nasiruddin-Shahi, describes Ghiyas-ud-din Khalji, the Sultan of Mandu (r. 1469–1500), watches as tender betel leaves of the finest quality are spread out and rosewater is sprinkled on them, while saffron is also added. An elaborate betel chew or paan would contain fragrant spices and rose preserves with chopped areca nuts.
It is a tradition in South India and nearby regions to give two Betel leaves, areca nut (pieces or whole) and Coconut to the guests (both male and female) at any auspicious occasion. Even on a regular day, it is the tradition to give a married woman, who visits the house, two Betel leaves, areca nut and coconut or some fruits along with a string of threaded flowers. This is referred to as thamboolam. Paan is symbol of Prosperity in indian tradition and part of most of rituals followed.
Betel leaf used to make paan is produced in different parts of India. Some states that produce betel leaf for paan include West Bengal, Bihar, Assam, Andhra Pradesh, Uttar Pradesh. In West Bengal, two types of betel leaves are produced. These are "Bangla Patta (Country Leaf)" and Mitha Patta (Sweet Leaf)". In West Bengal, Bangla patta is produced mainly in district of Dinajpur, Malda, Jalpaiguri, and Nadia. Mitha patta is produced in places such as Midnapur and South 24 Parganas.[citation needed]
The skilled paan maker is known as a paanwala in North India. In other parts, paanwalas are also known as panwaris or panwadis. At North India, there is a tradition to chew paan after Deepawali puja for blessings.
In the Indian state of Maharashtra, the paan culture is widely criticised due to the cleanliness problems created by people who spit in public places. In Mumbai, there have been attempts to paint pictures of Hindu gods in places where people commonly tend to spit, in the hope that this would discourage spitting, but success has been limited and there is need a solution at root to avoid peek. One of the great Marathi artists
Paan is losing its appeal to farmers because of falling demand. Consumers prefer chewing tobacco formulations such as gutka over paan. Higher costs, water scarcity and unpredictable weather have made betel gardens less lucrative.[21]
According to StraitsResearch, The India pan masala market is expected to reach US$10,365 million by 2026 at the CAGR of 10.4% during the forecast period 2019–2026. The India pan masala market is driven by significant switching of consumers from tobacco products to pan masala, aggressive advertising and convenient packaging, and Maharashtra State's revocation of the ban over pan masala products.[22]
Assam
In
Guests may be invited to a wedding reception by offering a few areca nuts with betel leaves. During
Paan-tamul is also offered to guests after the end of every feast, usually the paan-tamul-soon, or slaked lime with cardamom pods in it to freshen the breath.
Banarasi Pan
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Banarasi Pan of
Indonesia and Malaysia
Bersirih, nyirih or menginang is a historical
In the Malay Archipelago, the menginang or betel nut chewing has become a revered activity in local tradition; being a ceremoniously conducted gesture to honour guests. A complete and elaborate set of sirih pinang equipment is called tepak, puan, pekinangan or cerana. The set is usually made of wooden lacquerware, brass or silverwares; and it consists of the combol (containers), bekas sirih (leaf container), kacip (press-knife to cut areca nut), gobek (small pestle and mortar), and ketur (spit container).[26]
The Sirih Pinang has become a symbol of
Micronesia
Betel nut chewing is common among the native ethnic groups of
Areca palms have been grown traditionally in Guam, Palau, and Yap since ancient times. It spread to Chuuk in modern times. Betel nut stains have been found in ancient remains of the Chamorro people, indicating that the practice was carried into Micronesia by their Austronesian ancestors in Island Southeast Asia.[28]
Myanmar
Kwun-ya (ကွမ်းယာ [kóːn.jà]) is the word for betel quid in
Betel chewing has very long tradition in Burma, having been practised since before the beginning of recorded history.[30] Until the 1960s, both men and women loved it and every household used to have a special lacquerware box for betel quid, called kun-it (ကွမ်းအစ်), which would be offered to any visitor together with cheroots to smoke and green tea to drink.[31] The leaves are kept inside the bottom of the box, which looks like a small hat box, but with a top tray for small tins, silver in well-to-do homes, of various other ingredients such as the betel nuts, slaked lime, cutch, anise seed and a nut cutter.[31]
The sweet form (acho) is popular with the young, but grownups tend to prefer it with cardamom, cloves and tobacco. Spittoons, therefore, are still ubiquitous, and signs saying "No betel quid-spitting" are commonplace, as it makes a messy red splodge on floors and walls; many people display betel-stained teeth from the habit. Betel quid stalls and kiosks used to be run mainly by people of Indian origin in towns and cities. Smokers who want to quit would also use betel nut to wean themselves off tobacco.
An anecdotal government survey indicated that 40% of men and 20% of women in Myanmar chew betel.[33] An aggregate study of cancer registries (2002 to 2007) at the Yangon and Mandalay General Hospitals, the largest hospitals in the country, found that oral cancer was the 6th most common cancer among males, and 10th among females.[34] Of these oral carcinoma patients, 36% were regular betel quid chewers.[34] University of Dental Medicine, Yangon records from 1985 to 1988 showed that 58.6% of oral carcinoma patients were regular betel chewers.
Since the 1990s, betel chewing has been actively discouraged by successive governments, from the
Nepal
Paan is chewed mainly by Terai people, although migrants in Terai have also taken up chewing paan in recent times. Throughout Terai, paan is as common as anywhere in northern India. There is some local production, generally not commercial, but most leaves are imported from India. Although not as ubiquitous as in the Terai, most residents of Kathmandu occasionally enjoy paan. A sweet version of paan called meetha paan is popular amongst many who do not like the strong taste of plain (sada) paan. Some parents allow their children to consume meetha on special occasions because it is tobacco-free. [citation needed]
Pakistan
The consumption of paan has long been a very popular cultural tradition throughout
The culture of chewing paan has also spread in
The rate of oral cancer have grown substantially in Pakistan due to chewing of paan.[42][43][44]
Philippines
Betel nut chewing was formerly widespread in the indigenous
Betel nut chewing was described as being a "universal" practice among older people in the early 1900s. The most common configuration of the quid combines areca nut with slaked lime (usually made from heating crushed sea-shells) and betel leaves (tambul or siri). Tobacco may or may not be added.
In the native languages of the Philippines, betel nut chewing is known variously as buyo, bunga, hitso, or ngangà in
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Betel box from the Maranao people of Mindanao, Philippines, probably 20th century, copper alloy with silver inlay, Honolulu Museum of Art
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Betel quid preparations among theIraya Mangyan of Mindoro, Philippines
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Baliuag, Bulacan
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Illustration of three varieties of areca nuts once widely used in betel nut chewing in the Philippines, from Philippine Palms and Palm Products (1903)
Taiwan
In Taiwan betel quid is sold from roadside kiosks, often by the so-called betelnut beauties although these are becoming fewer and fewer (simplified Chinese: 槟榔西施; traditional Chinese: 檳榔西施; pinyin: bīnláng xīshī; Pe̍h-ōe-jī: pin-nn̂g se-si) – scantily clad girls selling a quid preparation of betel leaf, betel nuts, tobacco and lime. It is a controversial business, with critics questioning entrapment, exploitation, health, class and culture.[49]
-
Betelnut Beauty kiosk in Taiwan
Vietnam
In Vietnam, the areca nut and the betel leaf are such important symbols of love and marriage that in Vietnamese the phrase "matters of betel and areca" (chuyện trầu cau) were historically synonymous with marriage. Areca nut chewing starts the talk between the groom's parents and the bride's parents about the young couple's marriage. Therefore, the leaves and juices are used ceremonially in Vietnamese weddings.[50]
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Vietnamese betel nut kit from the Vietnam Museum of Ethnology
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Betel service kit from the Imperial court of the Nguyễn dynasty (c.19th century)
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Betel quid vendor
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A plate of betel nut
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A plate of betel nut in aVietnamese wedding
Effects on health
The
In one study (c. 1985),[57] scientists linked malignant tumours to the site of skin or subcutaneous administration of aqueous extracts of paan in mice. In hamsters, forestomach carcinomas occurred after painting the cheek-pouch mucosa with aqueous extracts or implantation of a wax pellet containing powdered paan with tobacco into the cheek pouch; carcinomas occurred in the cheek pouch following implantation of the wax pellets. In human populations, they reported observing elevated frequencies of micronucleated cells in buccal mucosa of people who chew betel quid in the Philippines and India.[57]
The scientists found that the proportion of micronucleated exfoliated cells is related to the site within the oral cavity where the paan is kept habitually and to the number of betel quids chewed per day. In related studies,[57] the scientists reported that oral leukoplakia shows a strong association with habits of paan chewing in India. Some follow-up studies have shown malignant transformation of a proportion of leukoplakias. Oral submucous fibrosis and lichen planus, which are generally accepted to be precancerous conditions, appear to be related to the habit of chewing paan.
In a study conducted in Taiwan,[58] scientists reported the extent of cancer risks of betel quid (paan) chewing beyond oral cancer, even when tobacco was absent. In addition to oral cancer, significant increases were seen among chewers for cancer of the oesophagus, liver, pancreas, larynx, lung, and all cancer. Chewing and smoking, as combined by most betel chewers, interacted synergistically and was responsible for half of all cancer deaths in this group. Chewing betel leaf quid and smoking, the scientists claimed, shortened the life span by nearly six years.
A
In a study conducted in Sri Lanka,[60] scientists found high prevalence of oral potentially malignant disorders in rural Sri Lankan populations. After screening for various causes, the scientists reported paan chewing to be the major risk factor, with or without tobacco.
In October 2009, 30 scientists from 10 countries met at the International Agency for Research on Cancer (IARC), a World Health Organization sponsored group, to reassess the carcinogenicity of various agents including the areca nut, They reported there is sufficient evidence that paan chewing, even without tobacco, leads to tumours in the oral cavity and oesophagus, and that paan with added tobacco is a carcinogen to the oral cavity, pharynx and oesophagus.[61]
Effects of chewing paan during pregnancy
Scientific teams from Taiwan, Malaysia and Papua New Guinea have reported that women who chew areca nut formulations, such as paan, during pregnancy significantly increase adverse outcomes for the baby. The effects were similar to those reported for women who consume alcohol or tobacco during pregnancy. Lower birth weights, reduced birth length and early term were found to be significantly higher.[62][63]
See also
- Domesticated plants and animals of Austronesia
- Betel container (Victoria & Albert Museum)
- Betel chewing in Thailand
- Betel chewing in China
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External links
- Nutritional composition of paan (archived 1 April 2011)
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans; International Agency for Research on Cancer (2004). Betel-quid and Areca-nut Chewing and Some Areca-nut-derived Nitrosamines. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 85. p. 2004. ISBN 978-92-832-1285-0.