Betel Quid with Tobacco (Gutka)
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Betel quid is a combination of betel leaf, areca nut, and slaked lime. In many countries, tobacco is also added, and the product is known as gutka, ghutka, or gutkha. Other ingredients and flavorants are also added according to local preferences and customs (e.g., sweeteners; catechu; or spices such as cardamom, saffron, cloves, anise seeds, turmeric, and mustard).1,2
Gutka is commercially available in foil packets/sachets and tins. It is consumed by placing a pinch of the mixture in the mouth between the gum and cheek and gently sucking and chewing. The excess saliva produced by chewing may be swallowed or spit out.2
Use
Betel quid and gutka use is reported to have stimulant and relaxation effects.2 Global estimates report up to 600 million men and women use some variety of betel quid.2
Betel quid with tobacco (gutka) is widely used in the following countries within the Indian subcontinent:1,2,3
Bangladesh
India
Pakistan
Betel quid with or without tobacco is also widely used in the following countries within Asia and the Pacific region:1,2,3,4
Cambodia
China
Indonesia
Malaysia
Myanmar
Papua New Guinea
Philippines
Sri Lanka
Taiwan
Thailand
Health Effects
The following conditions and cancers have been associated with using betel quid/gutka.
Precancerous conditions
Oral precancerous lesions, including erythroplakia (a reddened patch in the mouth) and leukoplakia (a white patch on the mucous membranes in the mouth that cannot be wiped off).2,5
Oral submucous fibrosis (OSF), a precancerous lesion that stiffens the soft pink tissue that lines the inside of the mouth (i.e., oral mucosa). OSF may extend into the esophageal tract. OSF is a debilitating and irreversible condition that often results in an inability to open the mouth. Treatment consists of cutting the fibrous bands in the mouth.2,5,6
Cancer
Oral cancers—predominantly carcinomas of the lip, mouth, tongue, and pharynx2,5,7
Cancer of the esophagus2
Other health effects
Reproductive health outcomes such as increased risk of having a low birth weight infant6
Nicotine addiction
Saturday, October 31, 2009
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