Fact Sheet
Betel Quid with Tobacco (Gutka)
(updated February 2007)
Definition
Betel quid with tobacco, also known as gutka (ghutka or
gutkha)
is a dry, relatively nonperishable commercial preparation that consists
of betel leaf (Piper betle), tobacco, areca nut (Areca catechu),
catechu (extract of the Acacia catechu tree), and slaked lime (calcium
hydroxide). Spices—such as cardamom, saffron, cloves, anise seeds, turmeric,
and mustard—or sweeteners are also added as flavorants.1,2 Gutka
is available in sachets and tins. It is consumed by placing a pinch of the
mixture in the mouth between the gum and cheek and gently sucking and
chewing.
The excess saliva produced by chewing may be swallowed or spit out.3
Gutka is primarily consumed in the Indian subcontinent (India,
Pakistan and Bangladesh). Betel quid without tobacco is widely used in Southeast Asian countries (Taiwan, Myanmar, Thailand, China, Papua New Guinea,
and Guam).3,7 In the Indian subcontinent, nonperishable, commercially
manufactured preparation of betel quid without tobacco is known as pan
masala, and a freshly prepared betel quid (with or without tobacco)
is known as pan.
Health Effects
Scientific studies examining the health effects of betel gutka have found it to be carcinogenic to humans. Specifically
the following cancers and conditions have been associated with using
gutka:
- Oral precancerous lesions (including leukoplakia and erythroplakia.)1,2
- Oral submucous fibrosis (OSF), a precancerous lesion characterized
by stiffness of the oral mucosa resulting in an inability to open the
mouth. OSF is an irreversible condition and treatment consists of cutting
the fibrous bands of the mouth. OSF may extend into the esophageal tract.2,4,5
- Oral cancers, predominantly squamous cell carcinomas of the lip,
mouth, tongue, and pharynx.3,5,6
- Esophageal cancer.2
- Reproductive health outcomes. One study found that pregnant women in India who used gutka
had a threefold increased risk of having a low birth weight infant.4
- Nicotine addiction7
Current Estimates of U.S. Prevalence
Gutka use is currently not monitored in the
United States.
References
- Gupta PC, Hamner JE III, Murti PR, editors.
Control of Tobacco-Related Cancers and Other Diseases. Proceedings
of an international symposium January 15–19, 1990 [cited 2007 Feb 27]; Bombay, India: Tata Institute
of Fundamental Research: Oxford University Press; 1992.
- National Cancer Institute, Centers for Disease Control and Prevention,
Stockholm Centre of Public Health. Smokeless Tobacco Fact Sheets.
3rd International Conference on Smokeless Tobacco; Stockholm. September 22–25, 2002 [cited 2007 Feb 27].
- International Agency for Research on Cancer (IARC).
Betel-Quid and Areca-Nut Chewing and Some Areca-Nut-Derived Nitrosamines; Volume 85
.
(PDF–44KB)
September 2004 [cited 2007 Feb 27]. Available from: http://monographs.iarc.fr/ENG/Monographs/vol85/volume85.pdf.
- Gupta PC, Ray CS.
Smokeless Tobacco and Health in India and South Asia.
Respirology 2003; 8(4):419–31 [cited 2007 Feb 27].
- Nair U, Bartsch H, Nair J.
Alert for an Epidemic of Oral Cancer Due to Use of the Betel Quid Substitutes
Gutkha and Pan Masala: A Review of Agents and Causative Mechanisms.
Mutagenesi 2004: 19(9): 251–62 [cited 2007 Feb 27].
- Gupta PC, Ray CS.
Epidemiology of Betel Quid Usage.
Annals Academy of Medicine Singapore. 2004; July 33(Suppl): 31S–36S [cited 2007 Feb 27].
- World Health Organization.
Tobacco: Deadly in Any Form or Disguise.
(PDF–257KB) Geneva; 2006 [cited 2007 Feb 27]. Available from: http://www.who.int/tobacco/communications/events/wntd/2006/Tfi_Rapport.pdf.
For Further Information
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO
Media Inquiries: Contact CDC's Office on Smoking and Health press line
at 770-488-5493.
Page last reviewed 02/28/2007
Page last modified 02/28/2007
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