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Last updated : August 23, 2017

What is betel nut?

Betel nut is the seed of the fruit of the areca palm. It is also known as areca nut. The common names, preparations and specific ingredients vary by cultural group and individuals who use it.

How is it used?

The seed is separated from the outer layer of the fruit and may be used fresh, dried, boiled, baked, roasted or cured.1

Betel quids

The most common method of using betel nut is to slice it into thin strips and roll it in a betel leaf with slaked lime (powder) or crushed seashells. This leaf package is known as a betel quid, betel nut chew, betel chew, betel pan or betel paan (India).2

Betel quids may also contain tobacco and other additives such as cloves, cardamom, nutmeg, aniseed, coconut, sugar, syrups and fruit extracts, to enhance the flavour.2

Sometimes areca nuts are rolled in leaves other than betel leaf, such as a leaf from the rubiaceous plant (Mitrogyna speciosa), nutmeg tree (Myristica fragrans), or the pepper plant used in kava (Piper methysticum).

Cultural practice

Betel nut chewing is an important cultural practice in some regions in south and south-east Asia and the Asia Pacific. It has traditionally played an important role in social customs, religious practices and cultural rituals.2

Some people from these regions who have settled in other countries have continued their cultural practice of chewing betel nut.2

Effects of betel nut

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Betel nut affects everyone differently, based on:

  • Size, weight and health
  • Whether the person is used to taking it
  • Whether other drugs are taken around the same time
  • The amount taken
  • The strength of the drug (varies from batch to batch)

The effects of betel nut are not fully understood and further research is needed. However, people who have used the drug have reported the following effects:

  • Mild euphoria and feelings of wellbeing
  • Feeling alert
  • Fast heart rate and palpitations
  • High blood pressure
  • Red face and feeling warm
  • Sweating3

People who use betel nut for the first time, and people who have used it before who take a large amount or a strong batch, may experience the following:

  • Tremors4
  • Dizziness
  • Upset stomach, diarrhoea, vomiting
  • Psychosis5

Long-term effects

Regular, heavy use of betel nut may eventually cause:

  • Discolouration of teeth and gums, sometimes turning them reddish-brown
  • Mouth ulcers and gum disease
  • Oral cancers or sub mucous fibrosis (a pre-cancer condition)
  • Stomach ulcer
  • Heart disease6
  • Needing to use more to get the same effect
  • Dependence on betel nut
  • Financial, work and social problems

Using betel nut with other drugs

The effects of taking betel nut with other drugs – including over-the-counter or prescribed medications – can be unpredictable and dangerous, and could cause:

  • Betel nut + tobacco: greatly increases the risk of developing oral cancers.2

Getting help

If your use of betel nut is affecting your health, family, relationships, work, school, financial or other life situations, you can find help and support.

Betel nut and the law

The active ingredient in betel nut is arecoline, which is a Schedule 4 poison (prescription only medicine) and therefore is illegal to possess or sell without proper authority.

Betel nut statistics

Around 10–20% of the world’s population chews betel nut in some form. This makes it the 4th most widely-used psychoactive substance, after nicotine, alcohol and caffeine.7,8

References

1. Gupta, P. & Ray, C. (2004). Epidemiology of betel quid usage.

2. World Health Organization. (2012). Review of areca (betel) nut and tobacco use in the Pacific: a technical report.

3. Lingappa, A., Nappalli, D., Sujatha, G., & Prasad, S. (2011). Areca Nut: To chew or not to chew?

4. Hafeman, D., Hibibul, A., Islam, T., & Louis, E. (2005). Betel quid: Its tremor-producing effects in residents of Araihazar, Bangladesh.

5. Huang, Z., Xioa, B., Wan, X., Li, Y., & Deng, H. (2003). Betel nut indulgence as a cause of epilepsy.

6. Shrihari, J., Blank, M., Balaster, R., Nichter, M., & Nichter, M. (2010.) Areca nut dependence among chewers in a South Indian community who do not also use tobacco.

7. World Health Organization. (2012). Review of Areca (betel) nut and tobacco use in the Pacific – A technical report. Geneva: World Health Organization.

8. Ashock, L., Deepika, N., Sujatha, G.P., & Shiva P.S. (2011). ‘Areca nut: To chew or not to chew?’. e-Journal of Dentistry, 1(3), 46–50.


Effects

diarrhoea, dizziness, fast heart rate, feeling alert, feeling of wellbeing, feelings of wellbeing, heart palpitations, high blood pressure, mild euphoria, psychosis, sweating, tremors, vomiting.

AKA

betel chew, betel paan, betel pan.