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{{Short description|Fruit of the areca palm chewed as a stimulant}}
{{cs1 config|name-list-style=vanc}}
{{For|the practice of chewing the areca nut|Betel nut chewing}}
{{Redirect|Supari|the 2003 film|Supari (film)}}
{{use dmy dates|date=November 2023}}
[[File:Bago, mercado 23.jpg|Areca nuts|thumb]]
[[File:Areca catechu - Köhler–s Medizinal-Pflanzen-014.jpg|19th century drawing of the Areca palm and its nut|thumb]]
[[File:Arecanutconsum1.PNG|thumb|upright=1.35|Areas of the world where the use of areca nut is common]]
The '''areca nut''' ({{IPAc-en|ˈ|ær|ᵻ|k|ə}} or {{IPAc-en|ə|ˈ|r|iː|k|ə}}) or '''betel nut''' is the fruit of the [[areca]] palm (''[[Areca catechu]]''). The palm is originally native to the [[Philippines]],<ref name="Zumbroich2007">{{cite journal |last1=Zumbroich |first1=Thomas J. |title=The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond |journal=eJournal of Indian Medicine |date=2007–2008 |volume=1 |pages=87–140 |url=https://ugp.rug.nl/eJIM/article/download/24712/22162}}</ref><ref name="powo">{{cite web |title=''Areca catechu'' L. |url=https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:664107-1 |website=Plants of the World Online |publisher=Royal Botanic Gardens Kew |access-date=2 May 2023}}</ref> but was carried widely through the tropics by the [[Austronesian expansion|Austronesian migrations]] and [[Spice trade|trade]] since at least 1500 BCE due to its use in [[betel nut chewing]].<ref name="Zumbroich2007"/> It is widespread in cultivation and is considered naturalized in much of the tropical Pacific ([[Melanesia]] and [[Micronesia]]), [[South Asia]], [[Southeast Asia]], and parts of east Africa. It is not to be confused with [[betel]] (''Piper betle'') leaves that are often used to wrap it. The practice of [[betel nut chewing]], often together with other herbs as a [[stimulant drug]], dates back thousands of years, and continues to the present day in many countries.

Betel nut chewing is addictive and causes adverse health effects, mainly [[Oral cancer|oral]] and [[esophageal cancer]]s, and cardiovascular disease. When chewed with additional tobacco in its preparation (like in [[gutka]]), there is an even higher risk, especially for oral and [[oropharyngeal cancer]]s. With tobacco it also raises the risk of fatal [[coronary artery disease]], fatal [[stroke]], and adverse reproductive effects including [[stillbirth]], [[Preterm birth|premature birth]], [[low birth weight]].

Consumption by hundreds of millions of people worldwide — mainly of South Asian or Southeast Asian origins — has been described as a "neglected global [[public health]] emergency".

==Etymology==
[[File:Grade1bottom.jpg|thumb|Areca nut]]
The term ''areca'' originated from [[Dravidian languages]], cognates of which are:<ref>{{cite book | last=Burrow | first=T. | last2=Emeneau | first2=M.B. | title=A Dravidian Etymological Dictionary | publisher=Clarendon Press | series=Digital dictionaries of South Asia | year=1984 | edition=2 | isbn=978-0-19-864326-5 | url=https://dsal.uchicago.edu/cgi-bin/app/burrow_query.py?qs=a%E1%B9%ADaikk%C4%81y&searchhws=yes&matchtype=exact | access-date=2024-10-10 | at=Entry 88}}</ref><ref>{{cite book | last = Krishnamurti | first = Bhadriraju | title = The Dravidian Languages | author-link = Bhadriraju Krishnamurti | publisher = Cambridge University Press | year = 2003 | isbn = 0-521-77111-0 | url=https://books.google.com/books?id=54fV7Lwu3fMC | page=9}}</ref>
* {{langx|ml|അടയ്ക്ക|translit=aṭaykka}}
* {{langx|kn|ಅಡಿಕೆ|translit=adike}}
* {{langx|ta|அடைக்காய்|translit=aḍaikkāy}}<ref name="MW_Collegiate">{{Citation |author=Merriam-Webster |author-link=Merriam-Webster |title=Merriam-Webster's Collegiate Dictionary |publisher=Merriam-Webster |url=http://unabridged.merriam-webster.com/collegiate/ |postscript=. |access-date=2015-03-24 |archive-date=2020-10-10 |archive-url=https://web.archive.org/web/20201010163505/https://unabridged.merriam-webster.com/subscriber/login?redirect_to=%2Fcollegiate%2F |url-status=dead }}</ref>
The terms dates back to the [[16th century]] when Dutch and Portuguese sailors took the nut from India to Europe.

== Description ==
[[File:Areca catechu nuts at Kadavoor.jpg|Areca fruits on a tree|thumb]]
[[File:Areca Nut Plantation in Nagercoil, Tamil Nadu, India. (4600092222).jpg|Areca nut plantation in India|thumb]]
[[File:Betel nut merchant.jpg|Betel nut saleswoman in [[Vanimo]], [[Papua New Guinea]] |thumb]]
The areca nut is not a [[true nut]], but rather the seed of a fruit categorized as a [[Berry (botany)|berry]]. It is commercially available in dried, cured, and fresh forms. When the husk of the fresh fruit is green, the nut inside is soft enough to be cut with a typical knife. In the ripe fruit, the husk becomes yellow or orange, and as it dries, the fruit inside hardens to a wood-like consistency. At that stage, the areca nut can only be sliced using a special [[scissors]]-like cutter.{{cn|date=August 2024}}

Usually for chewing, a few slices of the nut are wrapped in a [[betel]] leaf along with [[calcium hydroxide]] (slaked lime) and may include [[clove]], [[cardamom]], [[catechu]] resin (''kattha''), or other spices for extra flavouring. Betel leaf has a fresh, peppery taste, but it can also be bitter to varying degrees depending on the variety.{{cn|date=August 2024}}

Areca nuts are chewed for their effects as a mild stimulant,<ref>{{cite journal|author1=Gupta Prakash Chandra |author2=Ray Cecily S |title=Epidemiology of betel quid usage |journal=Ann. Acad. Med. Singap. |volume=33 |issue=4 Suppl |pages=31–6 |date=July 2004 |doi=10.47102/annals-acadmedsg.V33N4p31S |pmid=15389304 |url=http://www.annals.edu.sg/pdf200409/V33N4p31S.pdf |archive-url=https://web.archive.org/web/20090612061329/http://www.annals.edu.sg/pdf200409/V33N4p31S.pdf |archive-date=2009-06-12 }}</ref> causing a warming sensation in the body and slightly heightened alertness, although the effects vary from person to person.

The first nut cultivation in the world was done in Kyasanuru Seeme area of Shimoga district in Karnataka state of India. Even today the cultivators plant the same variety here. Kyasanuru variety gives high yield. Grows wildly in all regions.{{cn|date=August 2024}}

In parts of India, [[Sri Lanka]], and southern China, areca nuts are not only chewed along with betel leaf, but are also used in the preparation of [[Ayurvedic Medicine|Ayurvedic]] and [[Chinese herbology|traditional Chinese medicines]]. Powdered areca nut is used as a constituent in some [[dentifrice]]s.<ref name=Bhat>{{cite journal | last1 = Bhat | first1 = R. | last2 = Ganachari | first2 = S. | last3 = Deshpande | first3 = R. | last4 = Ravindra | first4 = G. | last5 = Venkataraman | first5 = A. | title = Rapid Biosynthesis of Silver Nanoparticles Using Areca Nut (Areca catechu) Extract Under Microwave-Assistance | doi = 10.1007/s10876-012-0519-2 | journal = Journal of Cluster Science | volume = 24 | pages = 107–114 | year = 2012 | s2cid = 94299039 }}</ref> Other traditional uses include the removal of [[tapeworm]]s and other [[intestinal parasite]]s by swallowing a few teaspoons of powdered areca nut, drunk as a [[decoction]], or by taking tablets containing the extracted alkaloids.<ref name=Bhat/> According to traditional Ayurvedic medicine, chewing areca nut and betel leaf is a good remedy against [[halitosis|bad breath]].<ref>[[Naveen Patnaik]], ''The Tree of Life''</ref>{{unreliable source?|date=June 2013}} Diplomat [[Edmund Roberts (diplomat)|Edmund Roberts]] noted that Chinese people would mix areca nut with ''[[Uncaria gambir]]'' during his visit to China in the 1830s.<ref name=Roberts1>{{cite book|last=Roberts|first=Edmund|title=Embassy to the Eastern Courts of Cochin-China, Siam, and Muscat|year=1837|publisher=Harper & Brothers|location=New York|page=138|url=http://www.wdl.org/en/item/7317/view/1/138/}}</ref> After chewing a betelnut, the red residue is generally spat out. Accordingly, places have banned chewing this nut to avoid [[eyesore]]s.<ref>{{cite web|url=https://ph.junctionnews.com/chewing-spitting-of-betel-nut-in-city-to-be-banned/|title=Chewing, spitting of betel nut in city to be banned|last=The Junction|date=2018-06-08|language=en-US|access-date=2019-04-23}}</ref><ref>{{cite web|url=http://www.baguioheraldexpressonline.com/chewing-spitting-of-betel-nut-in-city-to-be-banned/|title=Chewing, spitting of betel nut in city to be banned|last=Herald Express|date=27 May 2018|language=en-US|access-date=2019-04-23}}</ref><ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/australiaandthepacific/papuanewguinea/4140970/Papua-New-Guinea-bans-betel-nut.html|title=Papua New Guinea bans betel nut|journal=Daily Telegraph|last=Malkin|first=Bonnie|date=2009-01-06|access-date=2019-04-23|language=en-GB|issn=0307-1235}}</ref>

== Chemical composition ==
The major alkaloid in betel nut is [[arecoline]]. There are other compounds, such as [[arecaidine]], [[guvacine]], [[isoguvacine]], and [[guvacoline]].<ref name="pmid34457017">{{cite journal |vauthors=Chen X, He Y, Deng Y |title=Chemical Composition, Pharmacological, and Toxicological Effects of Betel Nut |journal=Evidence-Based Complementary and Alternative Medicine |volume=2021 |issue= |pages=1808081 |date=2021 |pmid=34457017 |pmc=8387188 |doi=10.1155/2021/1808081 |url= |issn=|doi-access=free }}</ref> [[Tannin]]s present in betel nut are mainly [[proanthocyanidin]]s along with catechins and arecatannin.<ref name="pmid34457017" /> Two new alkaloids were recently discovered and named acatechu A and acatechu B.<ref name="pmid31351128">{{cite journal |vauthors=Cao M, Yuan H, Daniyal M, Yu H, Xie Q, Liu Y, Li B, Jian Y, Peng C, Tan D, Peng Y, Choudhary MI, Rahman AU, Wang W |title=Two new alkaloids isolated from traditional Chinese medicine Binglang the fruit of Areca catechu |journal=[[Fitoterapia]] |volume=138 |issue= |pages=104276 |date=October 2019 |pmid=31351128 |doi=10.1016/j.fitote.2019.104276 |s2cid=198952787 |url= |issn=}}</ref> Several non-alkaloid compounds including benzenoids, [[terpenes]], [[carboxylic acid]]s, [[aldehyde]]s, alcohols, and [[ester]]s were also  identified.<ref>{{cite journal |last1=Zhang |first1=Pangzhen |last2=Sari |first2=Elizabeth Fitriana |last3=McCullough |first3=Michael J. |last4=Cirillo |first4=Nicola |title=Metabolomic Profile of Indonesian Betel Quids |journal=Biomolecules |date=13 October 2022 |volume=12 |issue=10 |pages=1469 |doi=10.3390/biom12101469 |pmid=36291678 |pmc=9599835 |issn=2218-273X|doi-access=free }}</ref>

==Health effects==
[[File:Spit from chewing Areca nut 02.JPG|Chewing betelnut produces a red residue, which is spat out|thumb]]
[[File:Lao woman chewing paan.jpg|thumb|upright=1.15|right|A woman with the characteristic red-stained teeth and gums from long term use.]]Chewing areca nut causes multiple forms of cancer and cardiovascular disease, with or without added tobacco.<ref name="WHOCancer2">{{cite book |author=IARC Working Group |url=http://monographs.iarc.fr/ENG/Monographs/vol85/mono85.pdf |title=Betel-quid and areca-nut chewing and some areca-nut-derived Nitrosamines |publisher=The World Health Organization |isbn=9789283215851 |access-date=13 October 2011 |archive-url=https://web.archive.org/web/20180329043217/http://monographs.iarc.fr/ENG/Monographs/vol85/mono85.pdf |archive-date=29 March 2018 |url-status=live}}</ref><ref>{{cite book |url=https://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf |title=WHO Report on the Global Tobacco Epidemic, 2008: the MPOWER package |publisher=World Health Organization |year=2008 |isbn=978-92-4-159628-2 |location=Geneva |archive-url=https://web.archive.org/web/20080308173338/http://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf |archive-date=8 March 2008 |url-status=dead}}</ref><ref>{{cite journal |last1=Warnakulasuriya |first1=S. |last2=Trivedy |first2=C |last3=Peters |first3=TJ |year=2002 |title=Areca nut use: An independent risk factor for oral cancer |journal=The BMJ |volume=324 |issue=7341 |pages=799–800 |doi=10.1136/bmj.324.7341.799 |pmc=1122751 |pmid=11934759}}</ref><ref>{{cite journal |last1=Dave |first1=Bhavana J. |last2=Trivedi |first2=Amit H. |last3=Adhvatyu |first3=Siddharth G. |year=1992 |title=Role of areca nut consumption in the cause of oral cancers. A cytogenetic assessment |journal=Cancer |volume=70 |issue=5 |pages=1017–23 |doi=10.1002/1097-0142(19920901)70:5<1017::AID-CNCR2820700502>3.0.CO;2-# |pmid=1515978 |s2cid=196365532}}</ref>

Betel nut chewing causes an increased risk of [[head and neck cancer]]s and [[esophageal cancer]].<ref name="NCI2">{{cite web |date=22 November 2019 |title=Oropharyngeal Cancer Treatment (Adult) (PDQ®)–Patient Version |url=https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq |access-date=28 November 2019 |website=National Cancer Institute |language=en}}</ref><ref>{{cite journal |last1=Secretan |first1=Béatrice |last2=Straif |first2=Kurt |last3=Baan |first3=Robert |last4=Grosse |first4=Yann |last5=El Ghissassi |first5=Fatiha |last6=Bouvard |first6=Véronique |last7=Benbrahim-Tallaa |first7=Lamia |last8=Guha |first8=Neela |last9=Freeman |first9=Crystal |last10=Galichet |first10=Laurent |last11=Cogliano |first11=Vincent |author12=WHO International Agency for Research on Cancer Monograph Working Group |display-authors=8 |year=2009 |title=A review of human carcinogens—Part E: Tobacco, areca nut, alcohol, coal smoke, and salted fish |journal=The Lancet Oncology |volume=10 |issue=11 |pages=1033–4 |doi=10.1016/S1470-2045(09)70326-2 |pmid=19891056}}</ref><ref>{{cite journal |vauthors=Jeng JH, Chang MC, Hahn LJ |date=September 2001 |title=Role of areca nut in betel quid-associated chemical carcinogenesis: current awareness and future perspectives |journal=Oral Oncology |volume=37 |issue=6 |pages=477–492 |doi=10.1016/S1368-8375(01)00003-3 |pmid=11435174}}</ref> Betel quid affects almost all parts of the human body, including the brain, heart, lungs, [[gastrointestinal tract]] and reproductive organs. It can cause [[myocardial infarction]], [[cardiac arrhythmia]]s, [[Hepatotoxicity|liver damage]], [[asthma]], [[type II diabetes]], [[hyperlipidemia]], [[metabolic syndrome]], [[hypothyroidism]], [[Benign prostatic hyperplasia|prostate hyperplasia]] and [[infertility]].<ref name="Garg-20143">{{cite journal |vauthors=Garg A, Chaturvedi P, Gupta PC |date=January 2014 |title=A review of the systemic adverse effects of areca nut or betel nut |journal=Indian Journal of Medical and Paediatric Oncology |volume=35 |issue=1 |pages=3–9 |doi=10.4103/0971-5851.133702 |pmc=4080659 |pmid=25006276 |doi-access=free}}</ref> Habitual chewing of areca nuts increases the risk of [[cirrhosis]] and [[hepatocellular carcinoma]].<ref name="stich">{{cite web <!-- "No authors listed" |display-authors=3 |last=HF |first=Stich |last2=MP |first2=Rosin |last3=KD |first3=Brunnemann |last4=U |first4=Nair |last5=H |first5=Bartsch |last6=J |first6=Nair |last7=M |first7=Blank |last8=L |first8=Deshpande |last9=RL |first9=Balster |last10=RV |first10=Prabhu |last11=V |first11=Prabhu |last12=L |first12=Chatra |last13=P |first13=Shenai |last14=N |first14=Suvarna |last15=S |first15=Dandekeri--> |date=2012 |orig-date=Updated: 2023-03-22 |title=Areca nut |url=https://www.ncbi.nlm.nih.gov/books/NBK590486/ |access-date=2023-11-02 |work=LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet] |publisher=National Institute of Diabetes and Digestive and Kidney Diseases |place=Bethesda, MD |pmid=37043595}}</ref> Chewing areca nuts is a cause of [[oral submucous fibrosis]], a condition which may progress to [[mouth cancer]].<ref name="Ray2019">{{cite journal |vauthors=Ray JG, Chatterjee R, Chaudhuri K |date=2019 |title=Oral submucous fibrosis: A global challenge. Rising incidence, risk factors, management, and research priorities |journal=Periodontology 2000 |volume=80 |issue=1 |pages=200–212 |doi=10.1111/prd.12277 |pmid=31090137 |s2cid=155089425}}</ref> It has also been linked to [[throat cancer]].<ref name="indonesia" />

When chewed with additional tobacco in its preparation (like in [[gutka]]), there is an even higher risk for cancer, especially for [[Oral cancer|oral]] and [[oropharyngeal cancer]]s.<ref name=":62">{{Cite journal |last1=Gormley |first1=Mark |last2=Creaney |first2=Grant |last3=Schache |first3=Andrew |last4=Ingarfield |first4=Kate |last5=Conway |first5=David I. |date=2022-11-11 |title=Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors |journal=British Dental Journal |language=en |volume=233 |issue=9 |pages=780–786 |doi=10.1038/s41415-022-5166-x |issn=0007-0610 |pmc=9652141 |pmid=36369568}}</ref> With tobacco it also raises the risk of fatal [[coronary artery disease]], fatal [[stroke]] and non-fatal ischaemic heart disease<ref name="VidyasagaranSiddiqi20163">{{cite journal |last1=Vidyasagaran |first1=A. L. |last2=Siddiqi |first2=K. |last3=Kanaan |first3=M. |year=2016 |title=Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis |url=http://eprints.whiterose.ac.uk/101100/1/EJPC_D_16_00085_R1_2016.pdf |journal=European Journal of Preventive Cardiology |volume=23 |issue=18 |pages=1970–1981 |doi=10.1177/2047487316654026 |issn=2047-4873 |pmid=27256827 |s2cid=206820997}}</ref><ref name=":22">{{Cite journal |last1=Gupta |first1=Ruchika |last2=Gupta |first2=Sanjay |last3=Sharma |first3=Shashi |last4=Sinha |first4=Dhirendra N |last5=Mehrotra |first5=Ravi |date=2019-01-01 |title=Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data |url=https://academic.oup.com/ntr/article/21/1/25/4793346 |journal=Nicotine & Tobacco Research |language=en |volume=21 |issue=1 |pages=25–31 |doi=10.1093/ntr/nty002 |issn=1469-994X |pmc=6941711 |pmid=29325111}}</ref>

Women who chew areca nut formulations, such as ''paan'', during pregnancy significantly increase adverse outcomes for the baby. Betel quid chewing can cause [[stillbirth]], [[Preterm birth|premature birth]], [[low birth weight]].<ref name="VidyasagaranSiddiqi201622">{{cite journal |last1=Vidyasagaran |first1=A. L. |last2=Siddiqi |first2=K. |last3=Kanaan |first3=M. |year=2016 |title=Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis |url=http://eprints.whiterose.ac.uk/101100/1/EJPC_D_16_00085_R1_2016.pdf |journal=European Journal of Preventive Cardiology |volume=23 |issue=18 |pages=1970–1981 |doi=10.1177/2047487316654026 |issn=2047-4873 |pmid=27256827 |s2cid=206820997}}</ref><ref>{{cite journal |last1=Senn |first1=M. |last2=Baiwog |first2=F. |last3=Winmai |first3=J. |last4=Mueller |first4=I. |last5=Rogerson |first5=S. |last6=Senn |first6=N. |year=2009 |title=Betel nut chewing during pregnancy, Madang province, Papua New Guinea |journal=Drug and Alcohol Dependence |volume=105 |issue=1–2 |pages=126–31 |doi=10.1016/j.drugalcdep.2009.06.021 |pmid=19665325}}</ref><ref>{{cite journal |last1=Yang |first1=Mei-Sang |last2=Lee |first2=Chien-Hung |last3=Chang |first3=Shun-Jen |last4=Chung |first4=Tieh-Chi |last5=Tsai |first5=Eing-Mei |last6=Ko |first6=Allen Min-Jen |last7=Ko |first7=Ying-Chin |year=2008 |title=The effect of maternal betel quid exposure during pregnancy on adverse birth outcomes among aborigines in Taiwan |journal=Drug and Alcohol Dependence |volume=95 |issue=1–2 |pages=134–9 |doi=10.1016/j.drugalcdep.2008.01.003 |pmid=18282667}}</ref>

The harm caused by consumption of areca nuts worldwide was classified in 2017 as a "neglected global [[public health]] emergency".<ref name=Mehrtash-2017>{{cite journal |display-authors=3 |vauthors=Mehrtash H, Duncan K, Parascandola M, David A, Gritz ER, Gupta PC, Mehrotra R, Amer Nordin AS, Pearlman PC, Warnakulasuriya S, Wen CP, Zain RB, Trimble EL |title=Defining a global research and policy agenda for betel quid and areca nut |journal=Lancet Oncology |volume=18 |issue=12 |pages=e767–e775 |date=1 December 2017 |pmid=29208442 |doi=10.1016/S1470-2045(17)30460-6}}</ref>

=== During pregnancy ===
Using tobacco or areca nuts during pregnancy significantly increases [[Teratogenic|adverse]] outcomes for the baby.<ref name=Kumar-2013>{{cite journal |last=Kumar | first=S |title=Tobacco and areca nut chewing—reproductive impairments: an overview |journal=Reproductive Toxicology (Elmsford, N.Y.) |volume=36 |pages=12–7 |date=April 2013  |pmid=23207167 |doi=10.1016/j.reprotox.2012.11.007 | bibcode=2013RepTx..36...12K }}</ref> The habit is associated with higher incidences of [[preterm birth]] and low [[birth weight]] and height.<ref name="Garg-2014">{{cite journal |vauthors=Garg A, Chaturvedi P, Gupta PC |date=January 2014 |title=A review of the systemic adverse effects of areca nut or betel nut |journal=Indian Journal of Medical and Paediatric Oncology |volume=35 |issue=1 |pages=3–9 |doi=10.4103/0971-5851.133702 |pmc=4080659 |pmid=25006276 |doi-access=free}}</ref> Biologically, these effects may be a consequence of the arecoline that is found in areca nuts.<ref name=Javed-2010>{{cite journal |vauthors=Javed F, Bello Correra FO, Chotai M, Tappuni AR, Almas K |title=Systemic conditions associated with areca nut usage: a literature review |journal=Scandinavian Journal of Public Health |volume=38 |issue=8 |pages=838–44 |date=December 2010  |pmid=20688790 |doi=10.1177/1403494810379291 |s2cid=32865681 |url=https://www.researchgate.net/publication/45508189}}</ref> The habit also exposes the fetus to various other toxic components [[Carcinogen|linked to cancer]].<ref name=Garg-2014/>

== Tradition ==
{{Main|Betel nut chewing}}
[[File:Paan60.jpg|Display of the items usually included in a chewing session: The betel leaves are folded in different ways according to the country and most have a little [[calcium hydroxide]] daubed inside. Slices of the dry areca nut are on the upper left hand and slices of the tender areca nut on the upper right. The pouch on the lower right contains tobacco, a relatively recent introduction.|thumb]]
[[File:Betel box from the Philippines, Mindanao, Maranao people, probably 20th century, copper alloy with silver inlay, HAA.JPG|A betel nut box crafted by the [[Maranao people]] of the [[Philippines]]|thumb]]
[[File:Betelnut-Cutter, Indonesia.JPG|Areca nut cutter from Indonesia|thumb]]
[[File:Betal-nut.jpg|Areca nut plantation in the Terai region of Nepal|thumb]]
Chewing the mixture of areca nut and betel leaf constitutes an important and popular cultural activity in many [[South Asia]]n, [[Southeast Asia]]n, [[East Asia]]n and [[Oceania|Oceanic]] countries. Why or when the areca nut and the betel leaf were first combined into one psychoactive drug is not known. Archaeological evidence from Thailand, Indonesia, and the Philippines suggests they have been used in tandem for at least 4000 years.<ref>{{cite web| url=http://www.epistola.com/sfowler/scholar/scholar-betel.html |title=Archaeological evidence from Thailand, Indonesia and the Philippines |publisher=Epistola.com |access-date=2014-06-10}}</ref>

The oldest unequivocal evidence of betel chewing is from the Philippines, specifically that of several individuals found in a burial pit in the [[Duyong Cave]] site of [[Palawan]] island dated to around 2680±250 BCE. The dentition of the skeletons is stained, typical of betel chewers. The grave also includes ''[[Anadara]]'' shells used as containers of lime, one of which still contained lime. Burial sites in [[Bohol]] dated to the first millennium CE also show the distinctive reddish stains characteristic of betel chewing. Based on linguistic evidence of how the reconstructed [[Proto-Austronesian]] term ''*buaq'' originally meaning "fruit" came to refer to "areca nut" in [[Proto-Malayo-Polynesian]], it is believed that betel chewing originally developed somewhere within the Philippines shortly after the beginning of the [[Austronesian expansion]] (~3000 BCE). From the Philippines, it spread back to Taiwan, as well as onwards to the rest of [[Austronesia]] and in neighboring cultures through trade and migration.<ref name="Zumbroich2007">{{cite journal |last1=Zumbroich |first1=Thomas J. |title=The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond |journal=eJournal of Indian Medicine |date=2007–2008 |volume=1 |pages=87–140 |url=https://ugp.rug.nl/eJIM/article/download/24712/22162}}</ref>

In Vietnam, the areca nut and the betel leaf are such important symbols of love and marriage that in [[Vietnamese language|Vietnamese]] the phrase "matters of betel and areca" (''chuyện trầu cau'') is synonymous with marriage.  The tradition of chewing areca nuts starts the talk between the groom's parents and the bride's parents about the young couple's marriage. Therefore, the leaves and juices are used ceremonially in Vietnamese weddings. The folk tale explaining the origin of this Vietnamese tradition is a good illustration of the belief that the combination of areca nut and the betel leaf is ideal to the point they are practically inseparable, like an idealized married couple.<ref>{{cite web |url=http://www.vietspring.org/legend/traucau.html |title=Vietnamese Legend |publisher=Vietspring.org |access-date=2014-06-10 |archive-url=https://web.archive.org/web/20140805204444/http://www.vietspring.org/legend/traucau.html |archive-date=2014-08-05 }}</ref>

Formerly, in both India and Sri Lanka, it was a custom of the royalty to chew areca nut with betel leaf. Kings had special attendants whose duty it was to carry a box with all the necessary ingredients for a good chewing session. There was also a custom for lovers to chew areca nut and betel leaf together, because of its breath-freshening and relaxant properties. A sexual symbolism thus became attached to the chewing of the nut and the leaf. The areca nut represented the male principle, and the betel leaf the female principle. Considered an auspicious ingredient in [[Hinduism]] and some schools of [[Buddhism]], the areca nut is still used along with betel leaf in religious ceremonies, and also while honoring individuals in much of southern Asia.<ref name="rrh">{{cite journal |last1=Auluck |first1=A |last2=Hislop |first2=G |last3=Poh |first3=C |last4=Zhang |first4=L |last5=Rosin |first5=MP |title=Areca nut and betel quid chewing among South Asian immigrants to Western countries and its implications for oral cancer screening |journal=Rural and Remote Health |date=14 May 2009 |volume=9 |issue=2 |page=1118 |pmid=19445556 |pmc=2726113 |url=https://www.rrh.org.au/journal/article/1118 |access-date=7 September 2019}}</ref>

In [[Assam]], as well as most of its neighbouring Northeastern states, Areca Nut is preferably consumed in its fermented form, which is supposed to make the fruit harder and sweeter. The raw nut may also be eaten during certain seasons when the fermented variety becomes unavailable, although it has more of ritual importance. Standard sized pieces of the nut and leaf are usually consumed in combination with lime and a bit of tobacco. In Assam, betel nut and leaf has indispensable cultural value; offering betel leaf and nut, (together known as ''gua'') constitutes a part of social greeting and socialising. It is a tradition to offer ''pan-tamul'' (betel leaves and raw areca nut) to guests immediately upon arrival, and after tea or meals, served in a brass plate with stands called  ''bota''. In traditional Assamese societies carrying a pouch of ''tamul-pan'' upon one's person during journeys or during farming activities, and sharing of the same, was an essential requirement. Among the Assamese, the areca nut also has a variety of uses during religious and marriage ceremonies, where it has the role of a fertility symbol. No religious ritual is complete without the offering of ''tamul-pan'' to the gods and spirits as well as to the assembled guests <ref>{{Citation|last1=Ahuja|first1=Uma|last2=Ahuja|first2=Siddharth|last3=Ahuja|first3=Subhash Chander |title=Betel Nuts|date=2016|encyclopedia=Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures|pages=877–882|place=Dordrecht|publisher=Springer Netherlands|isbn=978-94-007-7746-0 |doi=10.1007/978-94-007-7747-7_9835}}</ref> A tradition from Upper Assam is to invite guests to wedding receptions by offering a few areca nuts with betel leaves. During [[Bihu]], the ''husori'' players are offered areca nuts and betel leaves by each household while their blessings are solicited.{{cn|date=August 2024}}

Spanish mariner [[Álvaro de Mendaña de Neira|Álvaro de Mendaña]] reported observing [[Solomon Islands|Solomon Islanders]] chewing the nut and the leaf with caustic lime, and the manner in which the habit stained their mouths red. He noted the friendly and genial chief Malope, on [[Santa Isabel Island]], would offer him the combination as a token of friendship every time they met.<ref>Graves, Robert (1984), Las islas de la imprudencia, Barcelona: Edhasa. {{ISBN|84-350-0430-9}}</ref>

In [[Bhutan]], the areca nut is called ''doma''. The soft and moist raw areca nut is very potent. When chewed it can cause [[Palpitations|palpitation]] and [[vasoconstriction]]. This form is eaten in the lower regions of Bhutan and in North Bengal, where the nut is cut into half and put into a local ''paan'' leaf with a generous amount of lime. In the rest of Bhutan the raw nut, with the husk on, is fermented such that the husk rots and is easy to extract. The fermented doma has a putrid odour, which can be smelled from miles.{{citation needed|date=March 2017}} Traditionally, this fragrant nut is cut in half and placed on top of a cone made of local betel leaf, which has a dash of lime put into it. "Myth has it that the inhabitants of Bhutan traditionally known as Monyul, the land of Monpas where Buddhism did not reach lived on raw flesh, drank blood, and chewed bones. After the arrival of Guru Rinpoche in the eighth century, he stopped the people from eating flesh and drinking blood and created a substitute which is betel leaf, lime and areca nut. Today, chewing doma has become a custom. Doma is served after meals, during rituals and ceremonies. It is offered to friends and is chewed at work places by all sections of society and has become an essential part of Bhutanese life and culture."<ref>{{cite web |url=http://www.bhutan2008.bt/en/node/298 |title=Chewing doma: Myth to tradition &#124; Bhutan 2008 |access-date=2012-11-08 |archive-url=https://web.archive.org/web/20120409091824/http://www.bhutan2008.bt/en/node/298 |archive-date=2012-04-09 }}</ref>

The addition of tobacco leaf to the chewing mixture is a relatively recent innovation, as tobacco was not introduced from the [[Americas]] until the colonial era.

Reasons for starting to consume areca nuts appears to involve complex [[psychosocial]] factors.<ref name="More-2020">{{cite journal |vauthors=More C, Rao NR, More S, Johnson NW |date=June 2020 |title=Reasons for Initiation of Areca Nut and Related Products in Patients with Oral Submucous Fibrosis within an Endemic Area in Gujarat, India |journal=Substance Use & Misuse |volume=55 |issue=9 |pages=1413–1421 |doi=10.1080/10826084.2019.1660678 |pmid=32569538 |s2cid=219991434}}</ref>

== Modern-day consumption ==
[[File:Ashoka betel Nut Pack.JPG|Areca nut in small packs in India|thumb]]
[[File:Paan Making.jpg|Shopkeeper making ''paan'' in an Indian store|thumb]]
[[File:Kullan Koungu.jpg|An Areca nut dwarf variety sapling, [[Kerala]] state, India|thumb]]
[[File:Betel nut palms in Ponda, Goa.jpeg|Areca nut palm cultivation at a spice plantation in [[Curti, Goa]], India|thumb]]
[[File:Areca nuts in China 01.jpg|Areca nuts as sold in [[Hainan]], China|thumb]]
[[File:Areca nuts shown at one store in Suzhou.jpg|Areca nuts at a store in Suzhou, China|thumb]]
===South Asia===
In India (the largest consumer of areca nut) and the rest of the [[Indian subcontinent]], the preparation of nut with or without betel leaf is commonly referred to as ''[[paan]]''. It is available practically everywhere and is sold in ready-to-chew pouches called ''pan masala'' or ''supari'', which is the dried form of the areca nut, as a mixture of many flavours whose primary base is dried areca nut crushed into small pieces. Poor people, who may eat only every other day, use it to stave off [[Hunger|hunger pains]].<ref name=Javed-2010/><ref name=Collingham2006>{{cite book| last=Collingham| first=Lizzie | title=Curry: A Tale of Cooks and Conquerors| url=https://archive.org/details/curry00lizz| url-access=registration| year=2006| publisher=Oxford University Press| location=Oxford| isbn=978-0-19-988381-3|page=[https://archive.org/details/curry00lizz/page/7 7]}}</ref> ''Pan masala'' with a small quantity of tobacco is called ''[[gutka]]''. The easily discarded, small plastic ''supari'' or ''gutka'' pouches are a ubiquitous pollutant of the South Asian environment. Some of the liquid in the mouth is usually disposed of by spitting, producing bright red spots wherever the expectorate lands.{{cn|date=November 2023}}

In the [[Maldives]], areca nut chewing is very popular, but spitting is frowned upon and regarded as an unrefined, repulsive way of chewing. Usually, people prefer to chew thin slices of the dry nut, which is sometimes roasted. ''Kili'', a mixture of areca nut, betel, cloves, cardamom and sugar is sold in small home-made paper pouches. Old people who have lost their teeth keep "chewing" by pounding the mixture of areca nut and betel with a small mortar and pestle.{{cn|date=November 2023}}

===Southeast Asia===
In Thailand, the consumption of areca nut has declined gradually in the last decades. The younger generation rarely chews the substance, especially in the cities. Most of the present-day consumption is confined to older generations, mostly people above 50. Even so, small trays of betel leaves and sliced tender areca nut are sold in markets and used as offerings in Buddhist shrines.{{cn|date=November 2023}}

In the northern Philippines, particularly the [[Cordillera Administrative Region]], betel nut chewing remains prominent to the point that restrictions and fines have been established in urban areas such as [[Baguio|Baguio City]] in the [[Benguet]] province. These restrictions were made under the idea that ''momma'' or ''moma'' (betel nut) chewing and spitting are improper during public transportation drivers' work hours and are considered stains to the city roads and sidewalks.<ref>{{cite news |last=Gano |first=Hasreel |date=April 16, 2019 |title=Cordillera PUV drivers banned from chewing betel nut while on duty |work=Philippine News Agency |url=https://www.pna.gov.ph/articles/1067440 |access-date=November 20, 2023}}</ref> Despite these restrictions, betel nut thrives across the Cordilleran market. An example of its commerciality can be observed in [[Ifugao]], one of the provinces of the Philippine Cordilleras, where betel nuts are high-demand products sourced from the province's different cities and municipalities.<ref>{{cite journal |last=Latap |first=Nelson S. |date=June 2015 |title=Economic Assessment of Betel Nut (Areca cathecu) as Component in the Agroforestry (AF) Systems in Ifugao |journal=International Journal of Science and Research (IJSR) |volume=4 |issue=6 |pages=1896–1913 |url=https://www.academia.edu/71975264 |s2cid=21722318}}</ref>

In [[Bahasa Indonesia]], the betel nut is known as ''makan pinang'', while in the [[Papua Province]] of Indonesia, it is known simply as ''pinang''.<ref name=indonesia>{{cite web | title=Chewing Pinang a popular past time in Papua | website=Stichting Papua Erfgoed | url=https://www.papuaerfgoed.org/en/theme/chewing-pinang-popular-past-time-papua | access-date=2 November 2023}}</ref>

===Oceania===
[[File:Eating Pinang prohibited.jpg|Sign saying that chewing betel-nut is prohibited, at Sentani Airport, Jayapura, Papua Province, Indonesia|thumb]]
In [[Papua New Guinea]] (PNG), betel nuts are referred to in [[Tok Pisin]] as ''buai'', and grow abundantly on the northern coast, in [[Wewak]] and [[Madang]].<ref name=swanston2023>{{cite web | last1=Swanston | first1=Tim | last2=Gunga | first2=Theckla | title=Families from PNG's Manus province are losing their loved ones to the betel nut trade, with piracy posing a deadly risk | website=ABC News | date=5 October 2023 | url=https://www.abc.net.au/news/2023-10-06/betel-nut-trade-png-deadly-risks-and-piracy/102886664 | access-date=2 November 2023}}</ref> A controversial ban on selling and chewing betel nut in public places in [[Port Moresby]], introduced in 2014 by the governor, was lifted in 2017. Because the popular nut continued to be smuggled in, prices rose dramatically. Police enforced the ban rigorously, and in 2015 two betel nut sellers died in [[Hanuabada]] after police reservists fired on a crowd.<ref>{{cite web | last=Blades | first=Johnny | title=Betel nut ban lifted in PNG capital | website=RNZ | date=5 May 2017 | url=https://www.rnz.co.nz/international/pacific-news/330172/betel-nut-ban-lifted-in-png-capital | access-date=2 November 2023}}</ref> The governor of Port Moresby introduced another ban on the nut, restricted to an area in the business district of the city in July 2023. However many people make a living out of selling betel nut, so are resistant to bans in their areas.<ref>{{cite web | last=Evans | first=Kyle | title=Port Moresby Governor launches new attempt to ban betelnut| format= audio + text | website=ABC Pacific | date=5 July 2023 | url=https://www.abc.net.au/pacific/programs/pacificbeat/port-moresby-governor-launches-new-attempt-to-ban-betelnut/102568276 | access-date=2 November 2023}}</ref> On [[Manus Island]], young men are exposed to piracy when they use small boats to travel to the northern coast to purchase betel nuts to trade, and several have disappeared.<ref name=swanston2023/>

In Australia, the importation, use, and sale of areca nut is banned, but it has been sold illegally in several [[South Asian cuisine|South Asian]] supermarkets.<ref>{{cite web |title=Banned substance betel nut readily available for sale in Australia |url=https://www.sbs.com.au/yourlanguage/punjabi/en/article/2016/10/26/banned-substance-betel-nut-readily-available-sale-australia |website=SBS.com.au |access-date=2 July 2018}}</ref>

===East Asia===
In Taiwan, bags of 20 to 40 areca nuts are purchased fresh daily by a large number of consumers. To meet the steady year-round demand, two kinds of betel-nut shops sell betel and nuts, as well as cigarettes and drinks, including beer: Small [[mom and pop shop]]s, often poorly maintained and with unassuming [[Facade|façades]], and shops which will often consist of nothing more than a single, free-standing room, or booth. The latter is usually elevated one meter above the street, and measures less than 3 by 2 m. Large picture windows comprise two or more of the walls, allowing those who pass by a complete view of the interior. The interior is often painted brightly. Within such a shop, a [[sexily]] dressed young woman, a "[[betel nut beauty]]", can be seen preparing betel and areca nuts. Shops are often identified by colorful (commonly green) LED lamps or [[neon light]]s that frame the windows or that are arranged radially above a store. Customers stop on the side of the road and wait for the girls to bring their betel and areca nut to their vehicles. The habit of chewing betel nut is often associated with blue-collar labor industries such a long-haul transportation, construction, or fishing. Workers in these labor-intensive industries use betel nut for its stimulating effect, but it also becomes a tool for socializing with coworkers. For example, studies have shown chewing betel nut is prevalent among taxi, bus and truck drivers, who rely on the stimulating effect of betel nut to cope with long work hours.<ref>Chuang CY, Chang CH, Chang CC. The workplace relevant factors of betel quid chewing among transportation workers in Central Taiwan (in Chinese). Taiwan Journal of Public Health 2007; 26: 433–42.</ref><ref>{{cite web |title=Health Survey for the Long-distance Bus Drivers |language=zh |location=Taipei |publisher=Republic of China (Taiwan), Institute of Occupational Safety and Health, Council of Labor Affairs, The Executive Yuan |date=2003 |url=http://www.iosh.gov.tw/book/Report_Publish.aspx?PID=826&UID=F1165 |access-date=2011-08-18 |format=.zip |archive-url=https://web.archive.org/web/20120330223118/http://www.iosh.gov.tw/book/Report_Publish.aspx?PID=826&UID=F1165 |archive-date=2012-03-30}}</ref><ref>Kuo SC, Lew-Ting CY. The health lifestyles of areca quid-chewing taxi drivers – an exploratory study from the viewpoint of social context (in Chinese). Taiwan Journal of Oral Medical Science 2008; 27: 67–80.</ref> For these reasons, oral cancer has been identified as a leading cause of death in professions with high betel nut-chewing rates.<ref>Republic of China (Taiwan), Institute of Occupational Safety and Health, Council of Labor Affairs, The Executive Yuan. Analysis of the major causes of death of laborers in Taiwan (in Chinese). Taipei: Institute of Occupational Safety and Health, Council of Labor Affairs, The Executive Yuan, 2010. {{cite web |url=http://www.iosh.gov.tw/Print.aspx?cnid=16&p=1773 |script-title=zh:勞工安全衛生研究所友善列印新聞稿-我國勞工的主要死亡原因分析-惡性腫瘤(癌症)、事故傷害、心臟疾病是勞工朋友三大健康殺手 |website=Institute of Occupational Safety & Health |access-date=2011-08-18 |archive-url=https://web.archive.org/web/20120330223221/http://www.iosh.gov.tw/Print.aspx?cnid=16&p=1773 |archive-date=2012-03-30}}</ref>

In [[Hainan]] and [[Hunan Province]], China, where [[Xiangtan]] is a center of use and processing,<ref>{{cite news |url=https://www.nytimes.com/2010/08/20/world/asia/20hunan.html |title=Despite Risks, an Addictive Treat Fuels a Chinese City |author=Dan Levin |work=[[The New York Times]] |date=August 19, 2010 |access-date=August 20, 2010}}</ref> a wide range of old and young people consume areca nut daily. Most, though, consume the dried variety of the nut by itself, without the betel leaves. Some people also consume the areca nut in its raw, fresh form with or without the betel leaves. Betel nuts are sold mostly by old women merchants, but the dried version can be found in shops that sell tea, alcohol, and cigarettes.{{cn|date=November 2023}}

===Other countries===
In the United States, areca nut is not a controlled or specially taxed substance and may be found in some Asian grocery stores. However, importation of areca nut in a form other than whole or carved kernels of nuts can be stopped at the discretion of US Customs officers on the grounds of food, agricultural, or medicinal drug violations. <ref>{{cite web |url=https://www.publichealthlawcenter.org/sites/default/files/resources/Areca-Nut-Tobacco.pdf |title=Regulating Areca Nut, Betal Quite & Tobacco - Options and Opportunities |language=en-GB |website=www.publichealthlawcenter.org |access-date=2024-10-18}}</ref>

In the United Kingdom the betel nut is legal. <ref>{{cite web |url=https://www.drugwise.org.uk/betelnut/#:~:text=Unfortunately%2C%20chewing%20the%20nut%20can,the%20mouth%2C%20stomach%20and%20oesophagus.&text=Betel%20is%20legal%20in%20the%20UK.|title=Betel Nut - Drugwise |language=en-GB |website=www.drugwise.org.uk |access-date=2024-10-18}}</ref>

Possession of areca nut or betel leaf is banned in the [[United Arab Emirates|UAE]] and is a punishable offence.<ref>{{cite web |url=http://www.dubai.ae/en/Lists/HowToGuide/DispForm.aspx?ID=6 |title=Avoid bringing banned items into the UAE |language=en-GB |website=www.dubai.ae |access-date=2017-10-13}}</ref>

==Place names==
Places such as [[Guwahati]] in India, [[Penang]] in [[Malaysia]], [[Ko Mak]] (เกาะหมาก) in [[Thailand]], [[Fua Mulaku]] in [[Maldives]] and [[Binlang Islet]] in Taiwan have been named after the areca nut.{{cn|date=November 2023}}

== Production ==
In 2017, world production of areca nut was 1.3 million [[tonnes]], with India providing 54% of the total. As other leading producers, [[Myanmar]], Indonesia, Bangladesh and Taiwan combined contributed 38% of the world total (table).<ref name="faostat17">{{cite web |title=Areca nut production in 2017, Crops/Regions/World list/Production Quantity (pick lists) |url=http://www.fao.org/faostat/en/#data/QC|access-date=30 November 2019 |publisher=UN Food and Agriculture Organization, Corporate Statistical Database (FAOSTAT) |date=2019}}</ref>

{| class="wikitable left" style="width:18em;"
|+ Areca nut production
|-
! Country
! [[Tonne]]s<br /><small>(2017)</small>
|-
| {{IND}} || 723,000
|-
| {{MYA}} || 147,524
|-
| {{IDN}} || 136,837
|-
| {{BAN}} || 119,039
|-
| {{TWN}} || 102,165
|-
| '''World''' || '''1,337,115'''
|-
| colspan="2" style="text-align: center;" |<small>Source: [[FAOSTAT]], [[United Nations]]<ref name="faostat17" /></small>
|}

== See also ==
* [[List of herbs with known adverse effects]]
{{clear}}

== References ==
{{reflist}}

{{Commons category|Areca nut}}
{{Culture of Oceania}}
{{Nuts}}
{{Non-timber forest products}}

[[Category:Herbal and fungal stimulants]]
[[Category:Edible nuts and seeds]]
[[Category:Edible palms]]
[[Category:Fruit trees]]
[[Category:IARC Group 1 carcinogens]]
[[Category:Flora of the Maldives]]
[[Category:Medicinal plants of Asia]]
[[Category:Euphoriants]]
[[Category:Austronesian agriculture]]

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