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VOLUME 7 , ISSUE 4 ( October-December, 2016 ) > List of Articles


Prevalence of Areca Nut Eating Habits and its Association with Oral Submucous Fibrosis in Preuniversity Collegegoing Adolescents of Raichur in Karnataka, India: A Prospective Cross-sectional Survey

Basagoudanavar H Shrikrishna, AC Jyothi

Citation Information : Shrikrishna BH, Jyothi A. Prevalence of Areca Nut Eating Habits and its Association with Oral Submucous Fibrosis in Preuniversity Collegegoing Adolescents of Raichur in Karnataka, India: A Prospective Cross-sectional Survey. Int J Head Neck Surg 2016; 7 (4):197-203.

DOI: 10.5005/jp-journals-10001-1288

Published Online: 01-04-2012

Copyright Statement:  Copyright © 2016; The Author(s).



Oral submucous fibrosis (OSMF) is a well-known premalignant condition. Use of areca nut is a known cause of OSMF. More and more adolescents are becoming habitual to the use of areca nut and thus become prone for oral cancer.


To assess the prevalence of areca nut eating habits and its association with OSMF in the preuniversity college-going adolescents of Raichur in Karnataka, India.

Materials and methods

A prospective cross-sectional study was conducted among the preuniversity college-going adolescents. A questionnaire was asked to be filled by them with regard to areca nut eating habits. All of them were examined by a single examiner for the detection of OSMF.


Among the total of 1,208 adolescents included in the study, 527 were males and 681 were females. A total of 358 (29.64%) people accepted that they have the habit of eating areca nut. There was a significant association between areca nut eating habit and OSMF. There exists a significant relationship between the frequency and duration of areca nut eating habit with the presence of OSMF (p < 0.0001).


Areca nut eating habit is increasingly becoming prevalent among college-going adolescents. This needs to be addressed promptly by all concerned to prevent the occurrence of oral cancer.

How to cite this article

Shrikrishna BH, Jyothi AC. Prevalence of Areca Nut Eating Habits and its Association with Oral Submucous Fibrosis in Preuniversity College-going Adolescents of Raichur in Karnataka, India: A Prospective Cross-sectional Survey. Int J Head Neck Surg 2016;7(4):197-203.

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  1. Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 2001 Dec;22(6):764-779.
  2. Classification system for oral submucous fibrosis. J Indian Acad Oral Med Radiol 2012 Jan-Mar;24(1):24-29.
  3. Malignant transformation rate in oral submucous fibrosis over a 17-year period. Community Dent Oral Epidermol 1985 Dec;13(6):340-341.
  4. Oral sub mucous fibrosis: review on aetiology and pathogenesis. Oral Oncol 2006 Jul;42(6):561-568.
  5. Frequency of OSMF among 100 South Indians with oral cancers. Bull World Health Org 1965;32(5):750-753.
  6. Epidemiological studies of oral cancer. Int Dent J 1997 Jun;27:172-178.
  7. Etiology of oral submucous fibrosis with special references to the role of areca nut chewing. J Oral Pathol Med 1995 Apr;24(4):145-152.
  8. A dependency syndrome related to areca nut use. Some medical and psychological aspects among areca nut users in the UK. Addict Biol 2000 Apr;5(2):173-179.
  9. IARA monograph on the evaluation of the carcinogenic risk of chemicals to humans, Betel-quid and areca nut derived nitrosamines. Lyon International Agency for research on cancer. vol. 85. Lyon: IARC; 2004. p. 121-134.
  10. Tobacco and areca nut use in male medical students of Patna. Natl Med J India 2001 May-Jun; 14(3):176-178.
  11. HLA typing in Taiwanese patients with oral submucous fibrosis. J Oral Pathol Med 2004 Apr;33(4):191-199.
  12. Role of oxidative stress and antioxidants in aetiopathogenesis and management of oral submucous fibrosis. Indian J Clin Biochem 2004 Jan;19(1):138-141.
  13. ; Sivapathasundharam, B. Shafer, Hine, Levy. Shafer's textbook of oral pathology. 5th ed. Philadelphia: Elsevier publication; 2006. p. 136-139.
  14. ; Boucher, BJ.; Chen, TH.; Gajalakshmi, V.; Gupta, PC.; Hecht, SS.; editors. IARC working group on the evaluation of carcinogenic risk to humans: betel-quid and areca-nut chewing and some areca-nut-derived nitrosamines. Lyon: IARC Press; 2004.
  15. Global epidemiology of areca nut usage. Addict Biol 2002 Jan;7(1):77-83.
  16. A review of the systemic adverse effects of areca nut or betel nut. Indian J Med Paediatr Oncol 2014 Jan-Mar;35(1):3-9.
  17. Metabolic effects of the consumption of areca catechu. Addict Biol 2002 Jan;7(1):103-110.
  18. Areca (betel) nut chewing habit among high school children in the commonwealth of the northern Mariana islands (Micronesia). Bull World Health Organ 2005 Sep;83(9):656-660.
  19. A metabolonomic approach to the metabolism of the areca nut alkaloids arecoline and arecaidine in the mouse. Chem Res Toxicol 2006 Jun;19(6):818-827.
  20. The metabolomics of (±)-arecoline 1-oxide in the mouse and its formation by human flavin-containing monooxygenases. Biochem Pharmacol 2007 Feb;73(4):561-573.
  21. Neurological aspects of areca and betel chewing. Addict Biol 2002 Jan;7(1):111-114.
  22. Effects of arecoline on adipogenesis, lipolysis and glucose uptake of adipocytes-A possible role of betel-quid chewing in metabolic syndrome. Toxicol Appl Pharmacol 2010 Jun;245(3):370-377.
  23. Betel nut extracts and arecoline block insulin signalling and lipid storage in 3T3-L1 adipocytes. Cell Biol Toxicol 2011 Dec;27(6):397-411.
  24. Ultrastructural and hormonal modulations of the thyroid gland following arecoline treatment in albino mice. Mol Cell Endocrinol 2010 May;319(1-2):1-7.
  25. Modulation of platelet aggregation by areca nut and betel leaf ingredients: Role of reactive oxygen species and cyclooxygenase. Free Radic Biol Med 2002 May;32(9):860-871.
  26. Betel nut chewing and asthma. Lancet 1992 May;339(8802):1134-1136.
  27. Betel nut chewing causes bronchoconstriction in some asthma patients. P N G Med J 1994 Jun;37(2):90-99.
  28. Betel nut chewing during pregnancy, Madang province, Papua New Guinea. Drug Alcohol Depend 2009 Nov;105(1-2):126-131.
  29. Atrophia idiopathia (tropical) mucosa oris. Indian J Otolaryngol 1962;30:5-7.
  30. Correlation of salivary and serum IgG, IgA levels with total protein in oral submucous fibrosis. J Oral Sci 2011 Mar;53(1):97-102.
  31. The upregulation of lysyl oxidase in oral submucous fibrosis and squamous cell carcinoma. J Oral Pathol Med 1999 Jul;28(6):246-251.
  32. Increased tissue inhibitor of metalloproteinase-1 expression and inhibition of gelatinase A activity in buccal mucosal fibroblasts by arecoline as possible mechanisms for oral submucous fibrosis. Oral Oncol 2002 Feb;38(2):195-200.
  33. Stabilisation of collagen by betel nut polyphenols as a mechanism in oral submucous fibrosis. Experientia 1987 Apr;43(4):391-393.
  34. Alcohol drinking, body mass index and the risk of oral leucoplakia in an Indian population. Int J Cancer 2000 Oct;88(1):129-134.
  35. Risk factors for leucoplakia and malignant transformation to oral carcinoma: a leucoplakia cohort in Taiwan. Br J Cancer 2000 Jun;82(11):1871-1874.
  36. Epidemiological survey of oral submucous fibrosis and leucoplakia in aborigines of Taiwan. J Oral Pathol Med 2001 Apr;30(4):213-219.
  37. The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leucoplakia and oral submucous fibrosis in southern Taiwan. Br J Cancer 2003 Feb;88(3):366-372.
  38. Chewing tobacco, alcohol, and the risk of erythroplakia. Cancer Epidemiol Biomarkers Prev 2000 Jul;9(7):639-645.
  39. A case-control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 1990 Feb;19(2):94-98.
  40. Role of areca nut in the causation of oral submucous fibrosis: a case-control study in Pakistan. J Oral Pathol Med 1994 Feb;23(2):65-69.
  41. Oral submucous fibrosis in India: a new epidemic. Natl Med J India 1998 May-Jun;11(3):113-116.
  42. Oral submucous fibrosis, areca nut and pan masala use: a case-control study. Natl Med J India 1998 Nov-Dec;11(6):299.
  43. Role of chewing and smoking habits in the etiology of oral submucous fibrosis (OSF): a case-control study. J Oral Pathol Med 1998 Nov;27(10):475-479.
  44. Body mass index, tobacco chewing, alcohol drinking and the risk of oral submucous fibrosis in Kerala, India. Cancer Causes Control 2002 Feb;13(1):55-64.
  45. Oral precancerous disorders associated with areca quid chewing, smoking, and alcohol drinking in southern Taiwan. J Oral Pathol Med 2005 Sep;34(8):460-466.
  46. Prevalence of oral cancer and pre-cancer and associated risk factors among tea estate workers in the central Sri Lanka. J Oral Pathol Med 2007 Nov;36(10):581-587.
  47. The effects of chewing areca/betel quid with and without cigarette smoking on oral submucous fibrosis and oral mucosal lesions. Oral Dis 2005 Mar;11(2):88-94.
  48. Multiple logistic regression analysis of risk factors for carcinogenesis of oral submucous fibrosis in mainland China. Int J Oral Maxillofac Surg 2008 Dec;37(12):1094-1098.
  49. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India. J Indian Soc Pedod Prev Dent 2006 Jun;24(2):84-89.
  50. Intervention study for primary prevention of oral cancer among 36,000 Indian tobacco users. Lancet 1986 May;1(8492):1235-1239.
  51. Primary prevention trial of oral cancer in India: a 10-year follow-up study. J Oral Pathol Med 1992 Nov;21(10):433-439.
  52. Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10-yr follow-up study of 12,212 users. Oral Dis 1995 Mar;1(1):54-58.
  53. Challenges of the oral cancer burden in India. J Cancer Epidemiol 2012 Oct;2012:1-17.
  54. org. New Delhi: Planman Media Pvt. Ltd; 2008. [cited 2012 Nov 12]. Available from:
  55. An oral lichen planus-like lesion in Indian betel-tobacco chewers. Scand J Dent Res 1980 Jun;88(3):244-249.
  56. Survey of sociodemographic characteristics of tobacco use among 99 598 individuals in Bombay, India using handheld computers. Tab Control 1996 Summer;5(2):114-120.
  57. Use of tobacco and alcoholic beverages by children and teenagers in a low-income coastal community in South India. J Cancer Educ 1994 Summer;9(2):111-113.
  58. Socioeconomic status, life-style factors and oral premalignant lesions. Oral Oncol 2003 Oct;39(7):664-671.
  59. Cardiovascular responses to betel chewing. J Formos Med Assoc 1993 Sep;92(9):835-837.
  60. Tobacco habits other than smoking; betelquid and areca-nut chewing; and some related nitrosamines. IARC Working Group. Lyon, 23–30 October 1984. IARC Monogr Eval Carcinog Risk Chem Hum, 37: 1-268.
  61. Betel-quid and areca-nut chewing and some areca-nut derived nitrosamines. IARC Monogr Eval Carcinog Risks Hum, 85:1-334.
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