Tuesday, September 11, 2007

Taiwan's War on Betel-nut and Betel Palms


I'm starting to wonder if the people who are attacking betel nut usage and betel palm growing have a hidden agenda. Here's an issue that is being attacked from every possible angle.

First, just how strong is the link between cancer and the actual betel nut (just the nut)?

"Although a substantial proportion of the cancers are caused by the tobacco rather than the betel nut and leaves in the quid, according to WHO, betel chewing without tobacco also leads to cancer of the mouth. A British study reported in 2004 has tried to establish that there is a genetic aspect to this. Betel-nut chewers with faulty gene have higher risk of mouth cancer."

"When done regularly, betel chewing is considered likely to have harmful effects on health including cancers of the stomach and mouth and damage to gums. Whether this is due to, or exacerbated by, lime being used in betel preparations and the addition of tobacco (in the case of gutka) or other impurities is open to question. It is well known in betel consuming countries that various items, such as opiates and tobacco, can be added to betel preparations to increase the addictive properties, and thus to bolster sales."

"Very few studies exist of the use of a "pure" paan preparation: betel nut, betel leaf, and lime, and fewer studies exist of betel nut alone."

"Medical literature at this stage (even though highly anecdotal) seems to indicate that regular, addiction-driven use (for example, eight pinches a day) of betel nut in the preparations popular in India, Pakistan, New Guinea, and Taiwan can be harmful. Regarding the preparation methods used in Vietnam and Guam, and regarding occasional usage, there seems to be no strong indication one way or another." (WIKI)

So what's going on here? How strong is the evidence? Is what we're seeing here just a campaign to try and wipe out what some Taiwanese feel is an embarrassment to Taiwan or a real, full-blown medical problem here? Remember, "Betel chewing is a tradition which dates back thousands of years". Why wipe it out all of a sudden? Have the civilized and the professional had enough with this embarrassing, backward 1000 year old tradition.

As Chang Ming-hsien, chairman of the Kaohsiung Betel Nut Processing and Packaging Association feels...
'...there are too many moral judgments flying around. "People who use betel nut stands as a front for prostitution or drugs make up only a small proportion of us," he maintains. "If you say betel nuts cause cancer, make it clear which part of the nut actually does it. We can improve on that [by processing the nuts or changing the lime-paste formula]. Actually, I know a lot of old folk who love to chew betel nut and who've lived to be ninety years old, quite healthy. When their teeth fall out, they even grind betel nuts into powder. How do you explain that? If you say betel palms threaten the environment, what have you got to say about those massive golf courses built on slope land? Are they legal because golf players are all rich people and political VIPs, while betel nut chewers are blue-collar?" '

http://taiwanreview.nat.gov.tw/ct.asp?xItem=406&CtNode=128

Some consider it an attack on being Taiwanese:
' "Chewing betel nut is now considered a distinctly Taiwan custom, which means mainlanders don't do it. For the educated middle class, chewing betel nut, like speaking the Taiwanese dialect, helps create a sense of identity. "It's a Taiwanese tradition, part of our cultural heritage," says Wang Ming-teh, a computer salesman. '

There is also the often repeated link between betelnut palm's and their shallow roots and horrific landslides that occur in Taiwan. But is this actually so?

"Health advocates have it in for the betel nut, and so do the greens. Environmentalists say that when the trees are planted too close together (as they often are), the dense canopy of foliage makes it hard for other plants to flourish. That in turn means the land is prone to erosion and, in typhoon season, landslides. And some growers illegally plant the trees on slopes, where the potential for trouble is even greater."

Or could it be that Taiwan is just a crumbly place with landslides happening all the times for a variety of reasons, not excluding over development on a massive scale. Note, most of the landslides shown on TV remarkably show mostly rock and rubble and little or no trees. Why is that?

Legislator Su Chia-chuan,
"
[...]believes that the government's campaign against the betel nut is "part of their cultural inferiority complex. Taiwanese do it, but Westerners don't, so it must be low-class and disreputable." Betel-nut chewers would say just the opposite."

http://www.asiaweek.com/asiaweek/97/0711/feat2.html

Could it be that 'high-class' Taiwanese consider betel-nut culture something for poor countries in South East Asia to have but not their high tech, modern silicon island nation?

It is also interesting to note that these comments were made in 1997 when the KMT government was still in power. We know that the current pro-Taiwan government has maintained the anti-betel policy.

Look, I'm not advocating that betel-nut is completely healthy or that betel palms growing just anywhere is fine. I'm just suggesting that there quite likely are underlying reasons for eliminating betel-nut culture that are not completely obvious. This impression becomes even clearer when you consider the addition of the campaign against the morality of betel-nut girls, which officials are up in arms about, into the overall anti betel war.

In the end, the reason for getting rid of the drug of preference of the 'red-lipped people' (this term even seems pejorative!) may have more to do with prudish culture than with health or the environment or morality. So don't be fooled by all the popular media issues (that sell papers and keep viewers glued) and government propaganda.

Some other good reads:
http://www.epistola.com/sfowler/scholar/scholar-betel.html
A very detailed account of chewing or sucking the juice of betel-nut plus its effects, its appeal and health concerns related to it.

http://threecstaiwan.spaces.live.com/blog/cns!7BFCA5FB6183509D!688.entry
In defence of the betel-nut, kind of.

PS. BTW, not every issue is as one-sided as it may seem. I strongly recommend to stop always being spoon fed by the news media and the government. If you are interested in how this can happen, download this... mininova It's another very one-sided issue (which I believe something should still be done about) but the documentary will make you think about what you are being told and how it is packaged.

4 comments:

John Naruwan said...

Here's another perspective. Let's assume for a moment you want people to quit for health reasons alone. And let's say betelnuts are safe on their own and all the carcinogens are in the nasty slaked lime concoction that goes inside them. Well, why not just ban the paste? Is anyone going to chew plain betelnuts without that red paste? Not many. I bet a lot would actually quit.

You see what I'm getting at? If you want people to quit for health reasons, go after the paste rather than the nut itself because you can't really have one without the other.

Anonymous said...

I think atm its pretty clear that betel nut ( with or without lime, tobacco and alcohol) is not good for you...

It has been shown to be carninogenic in animals, and human studies ( not sure whats the ethical ground here) shows that betel nut causes pre-cancerous changes. So this would predispose affected people to developing cancer. Whether these pre-cancerous changes would eventually become neoplastic lesions ( or what percentage of them )... I think they are still waiting on this part of data.

Ref: Betel quid and areca nut are carcinogenic without tobacco. D.Sharma, Lancet oncology, p587 Volume 4, Issue 10, 2003.

Betel nut chewing is commonly practised in many parts in SE asia, and in taiwan indigenous communities it is part of their culture.
So a total ban of betel nut would be a bit insensitive, I think. But what they can at least do at this stage is to have betel nut sold in packets carrying warnings( like they do in India)... just in case that betel nut did turn out to be full-blown carcinogenic in humans...

Anonymous said...

There is sufficient evidence that the habit of chewing betel quid containing tobacco is carcinogenic to humans.

There is inadequate evidence that the habit of chewing betel quid without tobacco is carcinogenic to humans.
http://tinyurl.com/26cbl9

Oral squamous cell cancer is the most common malignant tumour in Papua New Guinea. We have found that oral cancer in this region is concentrated at the corner of the mouth and cheek, by striking contrast with western populations, and corresponds precisely with the site of application of lime in 77% of 169 cases. Powdered slaked lime applied to the chewed Areca nut with Piper betle inflorescence at the corner of the mouth causes the mean pH to rise to 10, at which reactive oxygen species are generated from betel quid ingredients in vitro. Reactive oxygen species, together with sustained lime-induced cell proliferation, suggest a possible mechanism of carcinogenesis for this tumour.Slaked lime and betel nut cancer in Papua New Guinea.SJ THOMAS.

The Working Group also concluded that, while there is sufficient evidence that the combined habits of smoking tobacco and chewing betel quid without tobacco cause oral and pharyngeal cancer, the evidence considered here does not allow an assessment of the possible contribution of betel quid without tobacco to this carcinogenic risk.

There is limited evidence that aqueous extracts of betel quid with and without tobacco are carcinogenic to experimental animals.

There is limited evidence that areca nut with and without tobacco is carcinogenic to experimental animals.

The data are inadequate to allow an evaluation of the carcinogenicity of betel leaf or arecoline to experimental animals.

Anonymous said...

There is sufficient evidence that the habit of chewing betel quid containing tobacco is carcinogenic to humans.

There is inadequate evidence that the habit of chewing betel quid without tobacco is carcinogenic to humans.

The Working Group also concluded that, while there is sufficient evidence that the combined habits of smoking tobacco and chewing betel quid without tobacco cause oral and pharyngeal cancer, the evidence considered here does not allow an assessment of the possible contribution of betel quid without tobacco to this carcinogenic risk.

There is limited evidence that aqueous extracts of betel quid with and without tobacco are carcinogenic to experimental animals.

There is limited evidence that areca nut with and without tobacco is carcinogenic to experimental animals.

The data are inadequate to allow an evaluation of the carcinogenicity of betel leaf or arecoline to experimental animals.

http://tinyurl.com/26cbl9

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