A Healthy Chew? Betel leaf versus tobacco

Tobacco chewing, also known as "smokeless tobacco", is a habit that affects about 3 per cent of the US population, with more chewers in the Southern states and a majority of chewers being young adults. Yet far from being a harmless alternative to cigarettes, tobacco chewing carries all the same cardiovascular risks as smoking, while in addition being a potent cause of oral cancer. The website of the American Academy of Otolaryngology lists the following ingredients of smokeless tobacco.

Polonium 210









Meanwhile, pān chewing is notorious throughout Asia and beyond as a source of stained teeth and oral cancer. Yet the habit is so ingrained that it has followed Asian migration paths around the world, with pān kiosks now being found in cities such as London. The classical texts of Ayurveda refer to tambula, or pān, as a typical part of daily routine. So is there a healthy chew? A safe alternative would give tobacco chewers and pān users a way to overcome their dangerous addiction.

Today, pān is a potent mix of betel leaf, areca nut, tobacco and slaked lime. Not only is the tobacco content carcinogenic, areca nut is also recognised by the WHO as a carcinogen in its own right.

So despite its high content of antioxidants such as gallic acid, areca nut should not be used on any consistent basis. Excess incidence of oral cancer is found even in communities that use traditional pān without tobacco. Areca nut also stains the teeth red and is the source of the unsightly red spittle so commonly seen in India. Confusion is added due to the fact that areca nut is commonly referred to as betel nut. However, areca nut is the seed of the areca palm, areca catechu, and is not in any way related to the betel leaf, piper betle, a member of the pepper family.

So what about betel leaf itself? Is that the solution for a healthy chew? According to an article in the South Asian Journal of Cancer, betel leaf has anti-diabetic, cardiovascular, anti-inflammatory, immunomodulatory, anti-ulcer, hepato-protective, anti-infective actions. It also improves digestion when chewed after meals. In animal studies, no carcinogenic effect was found from betel leaf alone. It has a mild stimulatory effect, although not as marked as the effect of tobacco.

This said, we don't have any long term studies on the effect of chewing betel leaf alone. So I would not recommend adopting betel leaf chewing as a long-term habit. However, chewing betel leaf could be used as a means of getting rid of the smokeless tobacco habit, or the betel nut pān habit. Someone trying to get off tobacco chewing could chew a mixture of tobacco and betel leaf, gradually reducing the amount of tobacco over the course of a month. Then they could chew betel leaf alone for about a month or two, gradually reducing the frequency of chewing in preparation for leaving the chewing habit behind completely. At that point, satisfy the need to chew by munching on pumpkin seeds, sesame seeds or dry dates.

Betel leaves are available at Indian grocery stores or can be purchased online.

Alakananda Ma M.B., B.S. (Lond.) is an Ayurvedic Doctor (NAMA) and graduate of a top London medical school. She is co-founder of Alandi Ayurveda Clinic and Alandi Ayurveda Gurukula in Boulder Colorado, as well as a spiritual mother, teacher, flower essence maker and storyteller. Alakananda is a well known and highly respected practitioner in the Ayurveda community both nationally and internationally.

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