There are 600 million people who regularly chew betel quid across Asia. It is the fourth most commonly used drug worldwide after alcohol, caffeine and tobacco.
Regular chewers suffer from teeth stains, gum pain, Oral Sub Mucous Fibrosis (high sensitivity and stiffness of jaws) and high risk of oral cancer.
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What is betel quid?
Betel quid usually consists of a combination of areca nut, calcium hydroxide, tobacco and spices wrapped in a betel vine leaf. This image shows finished betel quids ready to be chewed.
Betel vine leaf
The betel leaf is used to wrap all the other ingredients in. It is the leaf of a vine similar to pepper and kava.
The areca nut is the fruit from the areca palm (areca catechu). When combined with calcium hydroxide it has a wide range of effects including increased salivation, feelings of increased energy and relaxation
This is a caustic agent that raises alkalinity in the mouth which enables the areca nut and tobacco to be absorbed into the oral mucosa and then into the bloodstream, enabling these drugs to have their effect.
Dried tobacco is often sprinkled onto the preparation, resulting in a dual addiction to both the areca nut and tobacco. In Myanmar more than 80% of betel chewers add tobacco to their preparation.
Various spices are added to the final preparation, ranging from liquorice to sweetened tobacco.