Areca chewing in Xiangtan, Hunan province, China: interviews with chewers

BACKGROUND: To report on Areca chewing (AC) in Xiangtan, Hunan province, China, and to test the knowledge of chewers related to side effects of the habit. METHODS: Interviews with 276 individuals were performed. A questionnaire including general data, chewing habits, educational level and knowledge about side effects were used. Data were analysed using SPSS. Chi-square test was used at a significance level of P < 0.05. RESULTS: Around 257 individuals were chewers (male: 54.1%; female: 45.9%) and 19 were former chewers (male: 31.6%; female: 68.4%). Mean age of chewers was 36.1 years. Around 42.4% of chewers smoked; 58.0% had a drinking habit. Average period of chewing was 11.2 years. Around 88.3% of chewers did not include the nut (seed). Around 79.0% considered AC habits negative for general health and 85.2% for oral health. CONCLUSIONS: Most respondents did not know that AC may induce oral submucous fibrosis and oral cancer. The 'betel quid' chewed in Xiangtan usually does not contain Areca 'nut' (seed, endosperm), but consists of the husk. As no studies on the chemical composition of the Areca husk have been published such investigations are urgently needed.