Areca nut and tobacco chewing habits in Durban, KwaZulu Natal

Areca nut/quid chewing is a habit that is commonly practiced in the Indian subcontinent and this age-old social habit is still being practiced by the Indians in South Africa. The areca nut/quid is prepared in a variety of ways. The quid may be prepared with or without tobacco. This habit is said to be associated with the development of oral submucous fibrosis (OSF), a premalignant lesion, oral leukoplakia and oral cancer. The aim of the present study was to investigate the prevalence of areca nut/quid chewing (with or without tobacco), associated habits (smoking and alcohol consumption) as well as the awareness of the risks. The study was cross-sectional in design and used administered questionnaires and semi-structured interviews to collect the data. A convenience sample of 101 respondents was interviewed. More than three quarter were born in South Africa and the rest were migrant communities from Pakistan, India and Dubai. All respondents from the migrant community were males. Slightly more females than maleschewed areca nut/quid. Popular ingredients that were chewed included areca nut, betel leaf, lime and paan masala. Enjoyment and special functions were the most important reasons for chewing areca nut. Family influence was a reason for chewing. Nearly 60% did not know whether areca nut chewing is harmful to their health. The majority have not attempted to give up the habit. It is recommended that aggressive awareness programmes on the hazardous effects of areca nut/quid chewing be developed similar to those for smoking cessation. Government health warnings need to be written on paan packaging. Taxes need to be imposed on the areca nut and condiments. Age restrictions need to be imposed on purchasing of the areca nut/quid thus making access difficult for the children.