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Dear Editor
As a part of the community outreach initiatives of the British Columbia Oral Cancer Prevention Program, our team members recently participated in a local health fair at a multicultural health centre to educate and spread awareness about oral health and oral cancer. The attendees from the Indo-Canadian community presented us with an insightful perspective and questions.
It is routine and normal practice in Indian culture and tradition to chew betel quid (containing various amounts of betel leaf, lime, areca nut, and tobacco) after meals. The socially acceptable habit of betel-quid chewing is believed to aid digestion after food. Betel quid is also a taste enhancer and breath freshener, and is also used as traditional medicine for a variety of ailments1,2. The Indo-Canadian participants at the health fair informed us that they had never been told about the potential health threats, including the risk of developing oral cancer, associated with chewing betel quid. We were informed that many South Asian immigrant workers and farmers in and around Vancouver use betel quid, and that these betel-quid products for chewing are readily available in local Indian restaurants and shops.
A review of the literature revealed cases of oral pre-malignant lesions reported among East Indians and Indo-Canadians that are associated with this widespread habit3-5. Therefore it is important to spread awareness among Indo-Canadians and in other immigrant communities that this culturally accepted habit is rapidly emerging as a public health problem. It is also important to conduct studies regarding the demographics, level of awareness and socio-cultural beliefs relating to betel-quid chewing and oral health in this population, and also to offer oral cancer screening.
Ajit Auluck, MDS
Miriam Rosin, PhD
Greg Hislop, MCDM
British Columbia Cancer Agency
University of British Columbia
Vancouver, Canada
References
1. Norton SA. Betel consumption and consequences. Journal of the American Academy of Dermatology 1997; 37: 81-88.
2. Strickland SS. Antropological perspectives on use of the arecanut. Addiction Biology 2002; 7: 85-97.
3. Hayes PA. Oral submucous fibrosis in a 4 year old girl. Oral Surgery, Oral Medicnine, Oral Pathology 1985; 59: 475-478.
4. Morawetz G, Katsikeris N, Weinberg S, Listrom R. Oral submucous fibrosis. International Journal of Oral and Maxillofacial Surgery 1987; 16(5): 609-614.
5. Warnakulasuriya S. Areca nut use following migration and its consequences. Addiction Biology 2002; 7(1): 127-132.