Areca nut use making oral cancer fight tough

Nagpur: Until a few years ago, Buddhist priests in Sri Lanka used to give their sermons with mouthfuls of areca nut. Nowadays, in their sermons these priests include the disadvantages of areca nut addiction. In fact, the offerings made to the priests traditionally included areca nut, which the priests have started to discourage from being a part of the platter of offerings.These are some of the many social marketing initiatives taken by the anti-tobacco activists there, which can be easily replicated in India. These initiatives were discussed on the sidelines of an international symposium on oral submucous fibrosis that was inaugurated in the city on Saturday. Organized by Sharad Pawar Dental College to mark the silver jubilee of Datta Meghe Institute of Medical Sciences (DMIMS), the symposium had chief adviser of DMIMS Dr Vedprakash Mishra as chief guest, and Dr AT Biviji and Dr DK Daftary as the guests of honour. Sri Lanka-based Dr Saman Warnakulasuriya, the director of the World Health Organisation collaborating centre for oral cancer and precancer, was among the faculty. He also visited and interacted with the students of Government Dental College.
“I observed that most oral cancer and precancer patients that I saw in Nagpur were kharra chewers. There are 600 million people chewing areca nut in the world, mostly those in southeast Asia and Pacific region. Use of smokeless tobacco in the form of areca nut, betel quid and kharra is culturally acceptable in these areas. This makes it difficult to discourage people from the habit,” said Dr Warnakulasuriya. He added that the fight should not be against using these products in religious rituals but discouraging continuous, regular and frequent use of them.
In one of his studies, Dr Warnakulasuriya found areca nut to be the fourth most addictive product in the world, behind tobacco, alcohol and caffeine. “In another study that we carried in Sri Lanka, we found that oral cancer risk score of the betel quid was more than that of areca nut. I would imagine the situation to be similar in India, especially in the smaller town and villages. This can be dealt with by screening the population from these areas for precancer, identifying the high-risk groups and designing interventions for them,” he said.
“The one area India is doing very well in terms of fighting the smokeless tobacco menace is by formulating the right laws. The important issue of ensuring that schoolchildren don’t have access to tobacco products has already been addressed. Though laws are important, they are not sufficient in themselves. Efforts need to be made on a social level to change societal perceptions,” said Dr Warnakulasuriya. He added that a dialogue needs to be initiated with the masses where community and religious leaders can pitch in.