Skip to main content
SpringerLink
Log in

Areca Nut, Morbidity, and Cardiovascular Disease (Acute Coronary Syndrome): Implications for Policy and Prevention

  • Reference work entry
  • First Online:
Handbook of Substance Misuse and Addictions

  • 23 Accesses

Abstract

The consumption of areca nut is on the rise, particularly among adolescents and population belonging to South Asian countries. The high consumption can mainly be attributed to the lack of knowledge regarding its health hazards, accessibility, and low price. Regular consumption of areca nut can contribute to obesity, hypertension, diabetes, different types of cancers, and heart diseases. This chapter focus on the consumption of areca nut as a public health problem and a contributing factor for the acute coronary syndrome. Moreover, public health initiatives to minimize use of areca nut among different vulnerable groups are discussed.

In order to minimize the consumption of areca nut, initiatives are proposed to be planned and implemented by a multidisciplinary team, which may include public health specialist, cardiologist, psychologist, and social scientists. Moreover, suggested to conduct public health programs in a culturally specific manner, in local language, age and gender specific. The involvement of the influencers such as community and religious leaders, celebrities and use of social media such as Facebook are also recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 1,999.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ACS:

Acute coronary syndrome

HICs:

High-income countries

IVR:

Interactive voice response

LBW:

Low birth weight

LMICs:

Low-middle-income countries

SAPHF:

South Asian Public Health Forum

UK:

United Kingdom

WHO:

World Health Organization

References

  • Amarasinghe H, Warnakulasuriya S, Johnson NW (2021) Evaluation of a social marketing campaign for the early detection of oral potentially malignant disorders and oral cancer: Sri Lankan experience. J Oral Biol Craniofac Res 11(2):204

    Article  PubMed  PubMed Central  Google Scholar 

  • Asghar RJ (2006) Promoting regional health cooperation: the South Asian Public Health Forum. PLoS Med 3(5):e108

    Article  PubMed  PubMed Central  Google Scholar 

  • Berhan Nordin EA, Shoaib LA, Mohd Yusof ZY, Manan NM, Othman SA (2019) Oral health-related quality of life among 11–12 year old indigenous children in Malaysia. BMC Oral Health 19(1):152

    Article  PubMed  PubMed Central  Google Scholar 

  • Bhojani U, Varma A, Hebbar PB, Mandal G, Gupte H (2021) LifeFirst: impact of a school-based tobacco and supari cessation intervention among adolescent students in Mumbai, India. Popul Med 3(May):1–9

    Article  Google Scholar 

  • Boucher BJ, Mannan N (2002) Metabolic effects of the consumption of Areca catechu. Addict Biol 7(1):103–110

    Article  CAS  PubMed  Google Scholar 

  • Debreceni B, Debreceni L (2014) Role of vitamins in cardiovascular health and disease. Res Rep Clin Cardiol 5:283–295

    Google Scholar 

  • Donato-Hunt C, Munot S, Copeland J (2012) Alcohol, tobacco and illicit drug use among six culturally diverse communities in Sydney. Drug Alcohol Rev 31(7):881–889

    Article  PubMed  Google Scholar 

  • Dong X, Cai R, Sun J, Huang R, Wang P, Sun H et al (2017) Diabetes as a risk factor for acute coronary syndrome in women compared with men: a meta-analysis, including 10 856 279 individuals and 106 703 acute coronary syndrome events. Diabetes Metab Res Rev 33(5):e2887

    Article  Google Scholar 

  • Furber S, Jackson J, Johnson K, Sukara R, Franco L (2013) A qualitative study on tobacco smoking and betel quid use among Burmese refugees in Australia. J Immigr Minor Health 15(6):1133–1136

    Article  PubMed  Google Scholar 

  • Garg A, Chaturvedi P, Gupta PC (2014) A review of the systemic adverse effects of areca nut or betel nut. Indian J Med Paediatr Oncol 35(1):3

    Article  PubMed  PubMed Central  Google Scholar 

  • Guh J-Y, Chuang L-Y, Chen H-C (2006) Betel-quid use is associated with the risk of the metabolic syndrome in adults. Am J Clin Nutr 83(6):1313–1320

    Article  CAS  PubMed  Google Scholar 

  • Guh J-Y, Chen H-C, Tsai J-F, Chuang L-Y (2007) Betel-quid use is associated with heart disease in women. Am J Clin Nutr 85(5):1229–1235

    Article  CAS  PubMed  Google Scholar 

  • Gunjal S, Pateel DGS, Yang Y-H, Doss JG, Bilal S, Maling TH et al (2020) An overview on betel quid and areca nut practice and control in selected Asian and south east Asian countries. Subst Use Misuse 55(9):1533–1544

    Article  PubMed  Google Scholar 

  • Guo S-E, Huang T-J, Huang J-C, Lin M-S, Hong R-M, Chang C-H et al (2013) Alcohol, betel-nut and cigarette consumption are negatively associated with health promoting behaviors in Taiwan: a cross-sectional study. BMC Public Health 13(1):1–8

    Article  Google Scholar 

  • Gupta P, Warnakulasuriya S (2002) Global epidemiology of areca nut usage. Addict Biol 7(1):77–83

    Article  CAS  PubMed  Google Scholar 

  • Gupta B, Johnson NW, Kumar N (2016) Global epidemiology of head and neck cancers: a continuing challenge. Oncology 91(1):13–23

    Article  PubMed  Google Scholar 

  • Hosein M, Mohiuddin S, Fatima N (2015) Association between grading of oral submucous fibrosis with frequency and consumption of areca nut and its derivatives in a wide age group: a multi-centric cross sectional study from Karachi, Pakistan. J Cancer Prev 20(3):216

    Article  PubMed  PubMed Central  Google Scholar 

  • Hussain A, Zaheer S, Shafique K (2017) Individual, social and environmental determinants of smokeless tobacco and betel quid use amongst adolescents of Karachi: a school-based cross-sectional survey. BMC Public Health 17(1):913

    Article  PubMed  PubMed Central  Google Scholar 

  • Javed F, Bello Correra FO, Chotai M, Tappuni AR, Almas K (2010) Systemic conditions associated with areca nut usage: a literature review. Scand J Public Health 38(8):838–844

    Article  PubMed  Google Scholar 

  • Jayasinghe RD, Jayasooriya P, Amarasinghe H, Hettiarachchi P, Siriwardena B, Wijerathne U et al (2021) Evaluation of successfulness of capacity building programmes on smokeless tobacco and areca nut cessation. Asian Pac J Cancer Prev 22(4):1287–1293

    Article  PubMed  PubMed Central  Google Scholar 

  • Karim MT, Inam S, Ashraf T, Shah N, Adil SO, Shafique K (2018) Areca nut chewing and the risk of re-hospitalization and mortality among patients with acute coronary syndrome in Pakistan. J Prev Med Public Health 51(2):71

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee CH, Ko AMS, Warnakulasuriya S, Yin BL, Zain RB, Ibrahim SO et al (2011) Intercountry prevalences and practices of betel-quid use in south, southeast and eastern Asia regions and associated oral preneoplastic disorders: an international collaborative study by Asian betel-quid consortium of south and east Asia. Int J Cancer 129(7):1741–1751

    Article  CAS  PubMed  Google Scholar 

  • Lee C-H, Min-Shan Ko A, Warnakulasuriya S, Ling T-Y, Rajapakse PS, Zain RB et al (2012) Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: an Asian Betel-quid Consortium Study. Am J Public Health 102(3):e17–e24

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee C-H, Ko AM-S, Yang FM, Hung C-C, Warnakulasuriya S, Ibrahim SO et al (2018) Association of DSM-5 betel-quid use disorder with oral potentially malignant disorder in 6 betel-quid endemic Asian populations. JAMA Psychiatry 75(3):261–269

    Article  PubMed  PubMed Central  Google Scholar 

  • Lin W-Y, Chiu T-Y, Lee L-T, Lin C-C, Huang C-Y, Huang K-C (2008) Betel nut chewing is associated with increased risk of cardiovascular disease and all-cause mortality in Taiwanese men. Am J Clin Nutr 87(5):1204–1211

    Article  CAS  PubMed  Google Scholar 

  • Lin WY, Pi-Sunyer FX, Liu CS, Li TC, Li CI, Huang CY et al (2009) Betel nut chewing is strongly associated with general and central obesity in Chinese male middle-aged adults. Obesity 17(6):1247–1254

    Article  CAS  PubMed  Google Scholar 

  • Lopez A, Mathers C, Ezzati M, Jamison D, Murray C (2006) Global burden of disease and risk factors. Oxford University Press, New York

    Book  Google Scholar 

  • Mannan N, Boucher B, Evans S (2000) Increased waist size and weight in relation to consumption of Areca catechu (betel-nut); a risk factor for increased glycaemia in Asians in east London. Br J Nutr 83(3):267–275

    Article  CAS  PubMed  Google Scholar 

  • Mazahir S, Malik R, Maqsood M, Merchant KA, Malik F, Majeed A et al (2006) Socio-demographic correlates of betel, areca and smokeless tobacco use as a high risk behavior for head and neck cancers in a squatter settlement of Karachi, Pakistan. Subst Abuse Treat Prev Policy 1(1):1–6

    Article  Google Scholar 

  • Mehrtash H, Duncan K, Parascandola M, David A, Gritz ER, Gupta PC et al (2017) Defining a global research and policy agenda for betel quid and areca nut. Lancet Oncol 18(12):e767–e775

    Article  PubMed  Google Scholar 

  • Myint SK, Narksawat K, Sillabutra J (2016) Prevalence and factors influencing betel nut chewing among adults in West Insein Township, Yangon, Myanmar. Southeast Asian J Trop Med Public Health 47(5):1089–1097

    PubMed  Google Scholar 

  • Oakley E, Demaine L, Warnakulasuriya S (2005) Areca (betel) nut chewing habit among high-school children in the Commonwealth of the Northern Mariana Islands (Micronesia). Bull World Health Organ 83:656–660

    PubMed  PubMed Central  Google Scholar 

  • Ogunkolade WB, Boucher BJ, Bustin SA, Burrin JM, Noonan K, Mannan N et al (2006) Vitamin D metabolism in peripheral blood mononuclear cells is influenced by chewing “betel nut” (Areca catechu) and vitamin D status. J Clin Endocrinol Metabol 91(7):2612–2617

    Article  CAS  Google Scholar 

  • Overbaugh KJ (2009) Acute coronary syndrome. Am J Nurs 109(5):42–52

    Article  PubMed  Google Scholar 

  • Park ER, Gareen IF, Japuntich S, Lennes I, Hyland K, DeMello S et al (2015) Primary care provider-delivered smoking cessation interventions and smoking cessation among participants in the National Lung Screening Trial. JAMA Intern Med 175(9):1509–1516

    Article  PubMed  PubMed Central  Google Scholar 

  • Peng W, Liu Y-J, Wu N, Sun T, He X-Y, Gao Y-X et al (2015) Areca catechu L.(Arecaceae): a review of its traditional uses, botany, phytochemistry, pharmacology and toxicology. J Ethnopharmacol 164:340–356

    Article  CAS  PubMed  Google Scholar 

  • Placek C, Roulette C, Hudanick N, Khan A, Ravi K, Jayakrishna P et al (2019) Exploring biocultural models of chewing tobacco and paan among reproductive-aged women: self-medication, protection, or gender inequality? Am J Hum Biol 31(5):e23281

    Article  PubMed  PubMed Central  Google Scholar 

  • Prabhu N, Warnakulasuriya K, Gelbier S, Robinson P (2001) Betel quid chewing among Bangladeshi adolescents living in East London. Int J Paediatr Dent 11(1):18–24

    Article  CAS  PubMed  Google Scholar 

  • Ralapanawa U, Sivakanesan R (2021) Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: a narrative review. J Epidemiol Glob Health 11(2):169–177

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Readshaw A, Mehrotra R, Mishu M, Khan Z, Siddiqui F, Coyle K et al (2020) Addressing smokeless tobacco use and building research capacity in South Asia (ASTRA). J Glob Health 10(1):010327

    Article  PubMed  PubMed Central  Google Scholar 

  • Ruff CT, Braunwald E (2011) The evolving epidemiology of acute coronary syndromes. Nat Rev Cardiol 8(3):140–147

    Article  PubMed  Google Scholar 

  • Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A (2016) Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med 4(13):256

    Article  PubMed  PubMed Central  Google Scholar 

  • Senn M, Baiwog F, Winmai J, Mueller I, Rogerson S, Senn N (2009) Betel nut chewing during pregnancy, Madang province, Papua New Guinea. Drug Alcohol Depend 105(1–2):126–131

    Article  CAS  PubMed  Google Scholar 

  • Shafique K, Mirza SS, Vart P, Memon AR, Arain MI, Tareen MF et al (2012) Areca nut chewing and systemic inflammation: evidence of a common pathway for systemic diseases. J Inflamm 9(1):1–8

    Article  Google Scholar 

  • Siddiqi K, Shah S, Abbas SM, Vidyasagaran A, Jawad M, Dogar O et al (2015) Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Med 1(13):1–22

    Google Scholar 

  • Smith CJ, Ryckman K, Barnabei VM, Howard B, Isasi CR, Sarto GE et al (2016) The impact of birth weight on cardiovascular disease risk in the Women’s Health Initiative. Nutr Metab Cardiovasc Dis 26(3):239–245

    Article  CAS  PubMed  Google Scholar 

  • Thakur N, Sharma AK, Singh H, Mehrotra R (2020) ANDB: development of a database based on a global survey of literature on areca nut and associated health effects. Subst Use Misuse 55(9):1513–1518

    Article  PubMed  Google Scholar 

  • Thavarajah R, Ranganathan K, Joshua E, Rao UK (2019) Areca nut use disorder: a dynamic model map. Indian J Dent Res 30(4):612

    Article  PubMed  Google Scholar 

  • Vedanthan R, Seligman B, Fuster V (2014) Global perspective on acute coronary syndrome: a burden on the young and poor. Circ Res 114(12):1959–1975

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Winstock A (2002) Areca nut-abuse liability, dependence and public health. Addict Biol 7(1):133–138

    Article  CAS  PubMed  Google Scholar 

  • Winstock A, Trivedy C, Warnakulasuriya K, Peters T (2000) A dependency syndrome related to areca nut use: some medical and psychological aspects among areca nut users in the Gujarat community in the UK. Addict Biol 5(2):173–179

    Article  CAS  PubMed  Google Scholar 

  • Yamada T, Hara K, Kadowaki T (2013) Chewing betel quid and the risk of metabolic disease, cardiovascular disease, and all-cause mortality: a meta-analysis. PLoS One 8(8):e70679

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Yen AM-F, Chiu Y-H, Chen L-S, Wu H-M, Huang C-C, Boucher BJ et al (2006) A population-based study of the association between betel-quid chewing and the metabolic syndrome in men. Am J Clin Nutr 83(5):1153–1160

    Article  CAS  PubMed  Google Scholar 

  • Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R et al (2011) Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet 378(9798):1231–1243

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Public Health, Dow University of Health Sciences, Karachi, Pakistan

    Kashif Shafique & Sumaira Nasim

Authors
  1. Kashif Shafique
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sumaira Nasim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kashif Shafique .

Editor information

Editors and Affiliations

  1. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

  2. School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK

    Victor R. Preedy

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Shafique, K., Nasim, S. (2022). Areca Nut, Morbidity, and Cardiovascular Disease (Acute Coronary Syndrome): Implications for Policy and Prevention. In: Patel, V.B., Preedy, V.R. (eds) Handbook of Substance Misuse and Addictions. Springer, Cham. https://doi.org/10.1007/978-3-030-92392-1_83

Download citation

Publish with us

Policies and ethics

Search

Navigation