Betel‐quid dependence domains and syndrome associated with betel‐quid ingredients among chewers: anAsian multi‐country evidence

Abstract

DSM-IV criteria for dependence apply to a significant proportion of betel quid users in Asian communities, more so if they use it with tobacco or lime.

Arecoline inhibits intermediate-conductance calcium-activated potassium channels in human glioblastoma cell lines

“…Areca nut has long been used as a medical and psychoactive stimulant in China (Lee et al, 2014;Quinn Griffin et al, 2014) and was the leading cause for oral cancer (Nair et al, 1985;Shieh et al, 2004;Chen et al, 2008;Li et al, 2014). Arecoline (ARE; 1,2,5,6-tetrahydrol-1-methyl-3-pyridinecarboxylic acid methyl ester) is an alkaloid extracted from areca nut and is a non-selective agonist of muscarinic receptors and shown to have carcinogenicity, cytotoxicity and immunotoxicity (Dasgupta et al, 2006;Shih et al, 2010;Li et al, 2014).…”

Commentary on Lee et al. (2014): Betel‐quid—when East encounters West

“…One notorious downside is that betel-quid is identified as a human carcinogen by the World Health Organization [2]. Another dark side that is, as yet, little known concerns the probable dependence symptoms that betel-quid chewers may develop in terms of DSM-IV and ICD-10 criteria [3][4][5][6].Lee et al[6] conducted a large-scale survey across six Asian countries to investigate betel-quid dependence symptoms and syndrome among betel-quid chewers. Three primary conclusions can be drawn from their study.…”

“…Lee et al [6] conducted a large-scale survey across six Asian countries to investigate betel-quid dependence symptoms and syndrome among betel-quid chewers. Three primary conclusions can be drawn from their study.…”

“…The research conducted by Lee et al [6] has at least two advantages: (i) a large sample was recruited and (ii) various betel-quid types and ingredients were evaluated. A large sample size allowed the researchers to perform higher-level statistical analysis, facilitating the understanding of complicated relationships between dependence and chewing characteristics.…”

“…However, Lee et al [6] may have overlooked the influence of tobacco smoking on betel-quid dependence. This influence was observed in a survey of chewers in Malaysia, Indonesia and Sri Lanka who chewed both tobaccoadded and tobacco-free betel-quids.…”