Year: 2024
Type: preprint
Abstract: Stimulant Betel Quid, (SBQ) and SBQ with tobacco (SBQ+T) is chewed by hundreds of millions of people in Asia and the Pacific.Both SBQ and SBQ+T are addictive as determined by DSM-5 criteria and carcinogenic as determined by the International Agency for Research on Cancer monograph (IARC 2004).In light of these findings Asian governments and WHO advise abstinence as the recommended treatment for use and dependency.New human physiological research demonstrates that sections of the IARC monograph are incorrect and explain the chemical mechanism of the physiological stimulating action of SBQ.These findings suggest the possibility of the use of components of SBQ as a novel, culturally sensitive treatment and replacement therapy for SBQ dependency.Unfortunately, discussion of this topic remains marginalized because of an existing reverence for the IARC monograph by the medical and research community which has evolved to be philosophically reactionary and opposes the consumption of any components of SBQ even should these components be physiologically inactive or be used to reduce harm to the chewer.In short the development of culturally appropriate replacement therapies has not been pursued for 20 years because it deviates from a conservative philosophy generated from an influential historical document that is factually in error.Key words.Addiction, treatment, philosophy, betel quid, areca What is Stimulant Betel Quid and in what countries is it chewed ?Areca nut (AN) is the fruit of the Areca catechu palm.AN is uncommonly chewed by itself and since antiquity has been combined with slaked lime to become a quid with stimulant properties (Stimulant Betel Quid, SBQ).The flavor and addictive properties of SBQ can be modified by adding other spices and plants, most importantly tobacco (SBQ+T)[1].The geographical distribution of chewers is historically, distinctly Asian[2].It is chewed in a variety of forms from Nepal to Madagascar throughout the arc of Southeast Asia to Papua New Guinea and into the Pacific countries.Recent emigration of elderly Asians has delivered chewers into many Western countries.Chewing is generally a practice of under educated blue collar workers, laborers, farmers, fisherpeople and the elderly[3]. How many people chew ?Estimates of the number of people who regularly chew can only be made by combining unstandardized country and regional reports since SBQ or SBQ+T chewing has never been included in the United Nations World Drug Report (Statistical Annex Table 3.1) [4].It is routinely cited in the literature that 5-10 million people chew SBQ and 200-600 million people chew SBQ+T [1,3,5].This magnitude of use makes SBQs
Author: Peter Osborne
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4414899631
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