Sharing Taiwan’s Experience in Areca Nut and Betel Quid Control

  • Date: 2020-12-14
  • Update: 2020-12-14
  • Source: 國家衛生研究院
  • Views: 423

Sharing Taiwan’s Experience in Areca Nut and Betel Quid Control


December 14, 2020

Oral cancer is a major public health problem in Taiwan. This is largely attributable to the widespread habit of chewing areca nut and betel quid. Working together, scientists with the National Health Research Institutes, the Health Promotion Administration (HPA), and King’s College London have studied the incidence and current trends of oral cancer in Taiwan and how the government has been working to control betel quid use and prevent oral cancer among the Taiwanese population. Their findings were published in published a commentary in the international journal Oral Oncology on July 28.

In 1997 Taiwan declared December 3 “Areca Prevention Day” to raise public awareness about the hazards of areca/betel quid. Government agencies began collaborating with NGOs to create areca/betel quid-free supportive environments in communities, school campuses, military bases, and workplaces with high instances of betel quid chewing. The main tasks were to promote oral cancer awareness through the health care system, mass media, and school-based programs to halt an increase in new users, and to monitor the prevalence of areca nut chewing among adults and adolescents. Simultaneously, the HPA supported areca/betel quid cessation programs by designing culturally sensitive cessation teaching materials as well as identifying feasible strategies to implement betel quid cessation programs in high-risk communities and workplaces.

These programs have had significant success. The betel quid chewing rate in Taiwan has declined since 2007, according to national health surveys. And the decades-long increases in the age-standardized incidence rate of oral cancer have been halted, with the rate remaining flat since 2009.

Taiwan’s efforts have not been limited to education. Taiwan is the only country in the world that has initiated a sustained national oral cancer screening program. The HPA has targeted betel quid chewers (including ex chewers) and cigarette smokers older than 30 for oral mucosal screening every two years.

In addition, to decrease the supply of betel quid, the Council of Agriculture has worked to substitute areca trees with other cash crops. The Environmental Protection Administration enforces the Waste Disposal Act by prohibiting individuals from spitting betel quid juice, and any violators are fined and ordered to attend a four-hour betel-cessation class. To encourage active participation by employers in industries with high betel quid chewing rates, the Occupational Safety and Health Administration of the Ministry of Labor presents Golden Safety Awards to companies in recognition of their compliance with betel quid control policies.

As the researchers found, the efforts of the national areca nut and betel quid cessation program have had a significant positive impact on oral cancer prevention in Taiwan.

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