Tobacco and areca nut are used in a variety of forms and with other added ingredients throughout Asia and the Pacific. Common forms of areca nut use include: betel quid, a combination of betel leaf, areca nut, and slaked lime, which may be used with or without tobacco and is typically assembled for the customer;and gutka, a packaged product containing areca nut, slaked lime, and tobacco.. Other ingredients and flavorants are often added according to local preferences and customs (e.g., sweeteners; catechu; or spices such as cardamom, saffron, cloves, anise seeds, turmeric, and mustard). While both tobacco and areca nut are known carcinogens, other ingredients may also contribute to the toxic or addictive properties of the product.

Betel quid and areca nut use is common in Asian and Pacific countries. The 2009–2010 Asian Betel–Quid Consortium study found that use of betel quid with tobacco among adults aged 15 and older ranges widely across several countries in the region. For example, prevalence is high in Nepal (males, 43.6%; females, 34.9%) and among women in Indonesia (31.7% among females, compared to 10.4% among males). The CDC Global Adult Tobacco Survey in India (2009–2010) shows that about 6.2% percent of all adults aged 15 years and older (7.5% of males and 4.9% of females) report using betel quid with tobacco. Betel quid, is a risk factor for oral and esophageal cancers, and has shown effects on the cardiovascular, nervous, GI and metabolic, respiratory, and reproductive systems.

The International Agency for Research on Cancer Monograph 85 (2004) examined the carcinogenic effects of betel quid and areca nut chewing and concluded that betel quid, both with and without tobacco, is carcinogenic to humans. However, the relative contribution of specific ingredients to the carcinogenic and addictive properties of betel quid is not well characterized. Additionally, the practice of betel quid use, added ingredients, and cultural role vary widely across the region. Moreover, tobacco control policies and interventions are not necessarily applied to betel quid chewing, even when the product contains tobacco. More research is needed to understand effective prevention and control of betel quid use (alone or in combination with cigarette smoking and/or alcohol), screening and treatment for related cancers, policy and economic impacts, cessation, and basic biology.

This proposed conference will focus on understanding the impact of use of areca nut and betel quid, both with and without tobacco, and all its variants, addiction issues, and the associated cancers and other oral health issues, specifically cancers of the lip, mouth, tongue, pharynx, and esophagus. Specific agenda topics are outlined below.

Objectives

The goals of this conference as follows:

1. To identify research priorities and unanswered research questions regarding the use of areca nut and betel quid and cancer;

2. Identify evidence-based strategies for prevention and control;

3. To share relevant research findings from the field and highlight particular country examples of the translation of evidence to policy

4. To build a network of betel quid researchers and stimulate new research in the field;

5. To strengthen capacity among researchers in LMICs;

6. To explore the potential for e –health/m-health and other technology based interventions for areca nut and betel quid control in these communities.