Addressing a silent killer – WHO Western Pacific Region Sub-Regional Workshop on Betel (Areca) Nut and Tobacco Use

December 11, 2017, by Anita Das

Developing countries have faced significant challenges in bringing about reductions in tobacco use, and are expected to carry the bulk of the future health burden due to continued tobacco use. Moreover, tobacco use tends to be concentrated in lower income populations, even within low- and middle-income countries. One contributing factor here is that current, evidence-based tobacco control policies do not necessarily extend to hard-to-reach populations and those using non-cigarette products. One such population are chewers of areca nut, commonly referred to as betel quid. Areca nut use is common among U.S. territories in the Pacific (Guam and the Northern Mariana Islands), and in the U.S. affiliated Pacific Islands (Federated States of Micronesia, the Marshall Islands, and Palau). Although the actual global prevalence of areca nut chewing is not yet adequately documented, reports estimate that approximately 600 million individuals worldwide chew areca nut on a daily basis. Apart from the Western Pacific region, regular areca nut chewing is also prevalent in the South, Southeast and East Asian regions.

In April 2016, NCI organized the inaugural International Conference on Betel Quid and Areca Nut in Malaysia. This conference brought together international research experts in tobacco, betel quid, and areca nut. A variety of research recommendations were developed out of this conference, including the need for more qualitative research to build an understanding of the cultural norms and motivation associated with tobacco, betel quid and areca nut. Based on a 2012 WHO Technical Report: Review of Areca (Betel) Nut and Tobacco Use in the Pacific, WHO developed a tool kit focused on action planning workshop activities that seek to address tobacco and areca nut at the community level, which can help in reaching low income and rural populations.

Following discussion between NCI and the WHO Western Pacific Region office (WPRO), WHO organized and hosted the Sub-Regional Workshop on Betel (Areca) Nut and Tobacco Use in Manila, Philippines on November 29, 2017. The workshop brought together participants from Cambodia, Commonwealth of the Northern Mariana Islands, Federated States on Micronesia, Lao People’s Democratic Republic, Marshall Islands, Palau, Papua New Guinea, and Solomon Islands to learn about the use of areca nut and tobacco in the region and potential health impact. Discussion included banning areca nut use and sales in Papua New Guinea, engagement of civil society to address areca nut and tobacco use in the Marshall Islands, and raising health consequences of areca nut and tobacco use in the Federated States of Micronesia. Selected modules from the tool kit developed by WHO were used to discuss and develop action plans for the prevention and control of areca nut and tobacco use. Participants took part in situational assessment exercises and discussed existing and future areca nut and tobacco control activities within their countries.

It is our hope that the outcomes of this workshop will identify and facilitate effective community-based strategies and collaborations among countries and areas in the Western Pacific region.