National Addiction Centre, Institute of Psychiatry, London, UK.
Addict Biol. 2000 Apr 1;5(2):173-9. doi: 10.1080/13556210050003766.
Use of betel nut (areca nut) and its products is widespread, particularly in the Indo-Chinese continents, being the fourth most widely used substance after tobacco, alcohol and caffeine, affecting approximately 20% of the world's population. Betel nut, with or without admixed tobacco, is widely used among UK Indo-Asian immigrants, particularly Gujurate speakers. To date most research has concentrated on oral submucous fibrosis and malignancy. This paper reports detailed socio-demographic, clinical, laboratory and psychological studies in 11 current and former heavy betel nut users, referred by an Oral Medicine Unit in NW London. The patients, nine males, two females, had a high incidence of cardiovascular disease and truncal obesity. Laboratory investigations showed a high incidence of reduced serum B12 levels (4/9) and raised urinary cotinine levels (6/11), although none were current cigarette smokers. These findings are consistent with heavy usage of tobacco-areca combinations by this group. Routine biochemical and haematological investigations and clinical examination revealed no consistent abnormalities. Subjects had used areca for an average of 35 years with the mean age of first use being 13 years. Most subjects reported beneficial psychosocial effects. Ten subjects reported cessation withdrawal effects with the mean Severity of Dependence Score of 7.3. These findings are consistent with the existence of a dependency syndrome among those who use areca nut products. Further research is required to delineate the relative contributions of areca nut and tobacco to this clinical picture. Use of the areca nut, especially with tobacco, represents an area of health prevention among the UK minority populations that has, to date, been overlooked.
槟榔（槟榔果）及其制品的使用非常广泛，尤其在印度支那地区，是仅次于烟草、酒精和咖啡因的第四大常用物质，影响着全球约 20%的人口。无论是单独使用还是与烟草混合使用，槟榔果在英国的印度裔移民中都被广泛使用，尤其是古吉拉特邦的移民。迄今为止，大多数研究都集中在口腔黏膜下纤维性变和恶性肿瘤上。本文报告了 11 名目前和曾经大量食用槟榔果的患者的详细社会人口学、临床、实验室和心理研究，这些患者由伦敦西北部的一个口腔医学科转介而来。这些患者中有 9 名男性和 2 名女性，他们患有心血管疾病和躯干肥胖的比例较高。实验室检查显示，血清 B12 水平降低（4/9）和尿可替宁水平升高（6/11）的发生率较高，尽管他们都没有目前吸烟。这些发现与该组人群大量使用烟草-槟榔组合的情况一致。常规生化和血液学检查及临床检查均未发现一致的异常。这些患者食用槟榔的平均时间为 35 年，首次食用的平均年龄为 13 岁。大多数患者报告称，槟榔果对他们有有益的心理社会影响。10 名患者报告了戒断症状，其依赖严重程度平均评分为 7.3。这些发现与那些使用槟榔果产品的人存在依赖综合征的事实是一致的。需要进一步的研究来阐明槟榔果和烟草对这种临床情况的相对贡献。槟榔果的使用，尤其是与烟草混合使用，代表了英国少数族裔人群中一个被忽视的健康预防领域。
