Unsplash/Lex Guerra Smoking tobacco is one of the leading causes of preventable deaths

The International Agency for Research on Cancer (IARC), a subsidiary of the World Health Organization, released a new study on Tuesday in the journal "The Lancet Oncology," revealing the connection between the use of smokeless tobacco and betel nut and the risk of developing oral cancer. The research shows that global oral cancer cases caused by smokeless tobacco and betel nut account for approximately one-third of the total cases, with nearly 90% occurring in south-central Asia and over 95% in low- and middle-income countries.

Currently, about 300 million people worldwide use smokeless tobacco, and 600 million use betel nut, with the highest usage rates in South and Southeast Asia and Melanesia. Smokeless tobacco products can be used without burning through chewing, sucking, or applying. At the same time, betel nut is the fruit of the betel palm tree and can be used either alone or in combination with smokeless tobacco in the form of betel quid or betel nut.

Hazards of Smokeless Tobacco and Betel Nut

The study highlights that betel nut poses severe hazards. Compared to the use of smokeless tobacco alone, the use of betel nut products (whether they contain tobacco) leads to a higher proportion of oral cancer cases. It has a more severe impact on oral health.

Ramjai, the first author of the paper and a member of the IARC's Cancer Detection Department, emphasizes that smokeless tobacco and betel nut products come in various forms, but they are closely related to multiple diseases, including oral cancer, and pose a significant burden on global healthcare. Preventive strategies to reduce the consumption of smokeless tobacco and betel nuts are crucial.

Regional Differences

The research findings indicate that among the nearly 400,000 cases of oral cancer globally in 2022, over 120,000 cases may have been caused using smokeless tobacco and betel nut. Thus, preventing the use of smokeless tobacco and betel nuts could potentially prevent approximately one-third of oral cancer cases.

The study points out that over 95% of oral cancer cases caused by smokeless tobacco and betel nuts occur in low- and middle-income countries. South-central Asia, specifically India, Bangladesh, and Pakistan is the primary region with a high incidence of oral cancer cases, followed by Southeast and East Asia.

In terms of the proportion of oral cancer cases linked to smokeless tobacco and betel nut use across different regions of the world, Melanesia, Micronesia, and Polynesia have the highest rates, followed by South and Southeast Asia. The higher proportion of oral cancer cases in these regions is primarily due to the frequent use of smokeless tobacco and betel nuts.

Gender Differences

The research results show that among oral cancer cases caused by smokeless tobacco and betel nut use, 77% are male, and 23% are female. Although the risk of oral cancer is higher for men in most regions, in Southern Africa and Southeast Asia, the use of smokeless tobacco and betel nut among women exceeds that of men.

The study emphasizes the importance of developing gender-sensitive policies to ensure the reduction of betel nut, smokeless tobacco, and smoked tobacco use across different cultural backgrounds.

Urgent Preventive Measures

Isabella, Deputy Director of the IARC's Cancer Monitoring Department, states that while tobacco control has improved, progress in preventing smokeless tobacco use has been slow, and the regulation of betel nut remains inadequate. To reduce health inequalities, it is imperative to prioritize measures to control smokeless tobacco and incorporate betel nut prevention frameworks into global cancer prevention and control plans.