Betel quid (BQ)-chewing is a popular oral habit with potential links to the occurrence of oral cancer. Many of the literature-based studies reveal that areca nut (AN) extract may demonstrate mutagenic and genotoxic effects, in addition to inducing preneoplastic as well as neoplastic lesions in experimental animals. Areca nut should, thus, be highly suspected as a human carcinogen. Toxicity studies relating to AN-contained polyphenols and tannins are not conclusive, with both carcinogenic and anti-carcinogenic effects being reported. The mutagenicity and genotoxicity of areca alkaloids has been detected by many short-term assays. However, their genotoxicity to oral fibroblasts and keratinocytes, the target cells of BQ, has not been identified. It would thus appear that AN toxicity is not completely due to its polyphenol, tannin and alkaloid content. The single agent which is responsible for AN carcinogenicity awaits further clarification. Reactive oxygen species produced during auto-oxidation of AN polyphenols in the BQ-chewer's saliva, are crucial in the initiation and promotion of oral cancer. Nitrosation of areca alkaloids also produces AN-specific nitrosamines, that have been demonstrated to be mutagenic, genotoxic and are capable of inducing tumors in experimental animals. Arecaidine and AN extract are further suggested to be tumor promoters. Antioxidants such as glutathione and N-acetyl-L-cysteine can potentially prevent such AN-elicited cytotoxicity. Further studies are needed to delineate the metabolism of AN ingredient and their roles in the multi-step chemical carcinogenesis, in order to enhance the success of the future chemoprevention of oral cancer and oral submucous fibrosis.

ABSTRACT The areca nut, commonly known as betel nut, has been the subject of consistent scientific study over the past 5 decades. Betel nut is a natural compound chewed for its psychostimulating effects. Arecoline, the primary alkaloid of betel nut, is a muscarinic acetylcholine receptor agonist producing cholinergic effects on the parasympathetic nervous system and a psychoactive agent, contributing to the psycho-stimulating effects. Importantly the betel nut use is also associated with oral leucoplakia, submucous fibrosis, and squamous cell carcinoma. This narrative review explores the past, present, and future aspects of betel nut use, its historical applications, the development of biomarkers research, its health value concerns, and health economic impacts.

There are many reasons why people use addictive substances including the euphoric and stimulating effects they have. This article introduces the addictive substances Paan, Naswar, nicotine, and other related products. It also deals with their use by people who are not aware of their addictive properties and use them for their side effects as mouth freshener and tasty and fragrant snacks. Furthermore, they are marketed in beautiful and attractive packages for various age groups, even children and adolescents (who inadvertently use them, without being aware of their effects and over time become addicted to them). Therefore, providing information to, and constant education of, target groups can be effective in improving the public health.

<i>Background:</i> As a psychoactive substance that spans borders and cultures, researchers estimate that 600 million people use the areca nut. Despite its historical and geographical significance, betel nut use has received far less research attention than other stimulants such as tobacco, coffee or tea. Scholars have observed that social media platforms have significant effects on the promotion and use of addictive substances. <i>Objectives:</i> Our study investigates user practices and activities on a sample of Instagram posts tagged #betelnut dating back to 2011. <i>Methods:</i> Using social media analytics and hashtag network analysis, we examined user practices and activities on a sample of over 7800 Instagram posts tagged #betelnut dated between July 2011 to February 2019 that were collected in early 2019. <i>Results:</i> Findings determined that #betelnut is a growing topical hashtag on Instagram with content that drives social engagement. <i>Importance:</i> Co-occurring hashtags with #betelnut reflect regional language and cultural naming conventions that center around the Indian subcontinent and Melanesia. The importance of future work in this area is highlighted.

Abstract: Betel nut (BN), betel quid (BQ) and products derived from them are widely used as a socially endorsed masticatory product. The addictive nature of BN/BQ has resulted in its widespread usage making it the fourth most abused substance by humans. Progressively, several additives, including chewing tobacco, got added to simple BN preparations. This addictive practice has been shown to have strong etiological correlation with human susceptibility to cancer, particularly oral and oropharyngeal cancers.

containing cancer-causing substances, it is subjected in India to the same restrictions and warnings as cigarettes. Highly addictive and a known carcinogen Gutka is a type of betel quid and chewing tobacco preparation made of crushed areca nut (also called betel nut), tobacco, catechu, paraffin wax, slaked lime (calcium hydroxide) and sweet or savory flavourings, in India, Pakistan, other Asian countries, and North America. Using gutka is highly addictive and can cause various harmful effects such as head and neck cancer, oral and oropharyngeal cance Gutka is a type of betel quid and chewing tobacco preparation made of crushed areca nut (also called betel nut), tobacco, catechu, paraffin wax, slaked lime (calcium hydroxide) and sweet or savory flavourings, in India, Pakistan, other Asian countries, and North America. Using gutka is highly addictive and can cause various harmful effects such as head and neck cancer, oral and oropharyngeal cancers, coronary heart disease, as well as negative reproductive effects including stillbirth, premature birth and low birth weight. Gutka is manufactured in the sub-continent and exported to a few other countries, often marketed under the guise of a "safer" product than cigarettes and tobacco. Reported to have both stimulant and relaxation effects, it is sold throughout South Asia and some Pacific regions in small, individual-sized foil packets/sachets and tins that cost between 2 and 10 rupees each. It is widely consumed in Northern India, Pakistan and the Madhesh region of Nepal. Gutka is consumed by placing a pinch of it between the gum and cheek and gently sucking and chewing, similar to chewing tobacco. Due to containing cancer-causing substances, it is subjected in India to the same restrictions and warnings as cigarettes. Highly addictive and a known carcinogen, gutkha is the subject of much controversy in India. Many states have sought to curb its immense popularity by taxing sales of gutkha heavily or by banning it. Use of gutka and other forms of tobacco are culturally ingrained and use can begin at a young age. Smokeless tobacco use is most common in India where oral cancer accounts for 30 to 40% of cancer cases. Its use has been reported in Thailand, Sri Lanka, Bangladesh, Pakistan, Malaysia, Cambodia, China, Indonesia and New Guinea. Immigrants to the United Kingdom, parts of Africa, Australia, North America have brought their…