Asia’s deadly addiction

Ling Ling, 20, stands by the side of a highway on the outskirts of Taipei.

The top she wears is tight, and the transparent miniskirt she’s wearing reveals a tattoo on her hip. She’s waiting for truck drivers or working men to stop and buy her goods. In most other cities, it might be assumed those ‘goods’ were sexual services. But not here.

Ling Ling sells betel nuts, an addictive snack that is hugely popular in Taiwan, India, Myanmar and other parts of Asia, reports CNN. ‘The more beautiful you are, the more money you can make,’ she says. ‘That’s why I dress like this.’

Deadly and addictive
Chewed by almost a tenth of the world’s population, betel nuts - or quids as they are sometimes referred to - are the fourth most commonly used psychoactive substance after tobacco, alcohol and caffeinated drinks, according to World Health Organization.

Along the streets and highways in Taiwan, neon-lit booths with scantily clad ‘betel nut beauties’ serve customers who pull up in their cars or trucks.

Often wrapped in betel leaves, or paan, and chewed like a large fibrous chewing-gum, the betel nut gives a buzz on a par with several shots of espresso or, some say, amphetamine.

But, unlike a daily cup of coffee, the buzz can also be deadly - giving user’s mouth cancer. Shockingly, in Taiwan, around nine out of 10 oral cancer patients have a habit of chewing betel nut.

Explosive taste
Chen Wen, a taxi driver, says it helps him work long hours as he spits the red juice from a nut into a plastic cup.
‘When I chew betel nuts I can work much longer. It’s great!’

Some of the girls tell me that chewing betel nuts will give me a ‘spiritual lift.’ Others say it cures a hangover in no time. They come in different flavors, prepared with tobacco, lime or spices. Sweet and bitter are the most popular tastes.

Later, I spot a man leaning against his motorbike while casually munching away on a ‘binlang,’ which is the Mandarin for betel nut. He asks if I want to try and gives me a nut from his bag. It’s wrapped in a paan leaf and prepared with drops of a bitter paste that he claims is a sort of Chinese medicinal alcohol.

The taste is explosive.
Just a few seconds after popping it in my mouth and starting chewing an instant shock hits my body. My body temperature soars and I feel sweat breaking out in my face. My heartbeat quickly goes up. The strangest feeling is a tingling on my forearms and I can see the hair on my arms rising. And yes, I feel a massive buzz.

At the same time, my mouth quickly fills up with saliva and I have to spit. It’s then I notice puddles of red juice all over the pavement. The female hawkers and fellow chewers standing close by all break out in giggles.

Cancer-causing buzz?
However, consumption of betel nuts is far from a laughing matter. The tradition is under fire for its negative health impacts and several medical research studies show that chewing betel nuts is highly carcinogenic.

More than 5,700 Taiwanese people are diagnosed with oral cancer each year, 2,300 of whom are killed by the disease, according to statistics compiled by the Ministry of Health and Welfare in 2012.

Many sellers and chewers tell me that it`s only the leaves that are harmful, while the nut actually is healthy. But the International Agency for Research on Cancer (IARC) regards the betel nut itself to be a carcinogen.

Hahn Liang-Jiunn, the chairman of the Taiwan Alliance for Areca Nut Control and Oral Cancer Prevention, says there are several reasons why chewing betel nuts is so popular in Taiwan despite the health risks.

Many people who work outdoors - such as construction workers, long-distance drivers or fishermen - feel they get energy from chewing. It also keeps them warm and stops them feeling thirsty, he explained. There’s also a social aspect to it.

‘It’s actually easier to make friends by chewing betel nuts than by smoking cigarettes,’ said Hahn, who is also a professor emeritus at National Taiwan University Hospital. ‘That’s why many young people start chewing at such an early age.’

Kicking the habit
Taiwan is pushing people to kick the habit. Since 2014, anyone caught spitting betel nut juice in the capital of Taipei is fined and required to attend withdrawal classes.

Taiwan is also trying to incentivize local farmers to change crops and cut the supply of the betel nut. Some 4,800 hectare of betel nut farming land is expected to be planted with crops like tea, citrus fruit or mango, according to Hahn.

What’s more, the betel nut beauties have been subject to clothing restrictions. Similar steps are being seen elsewhere - albeit with mixed results.

Police in Papua New Guinea are setting up roadblocks to check whether people are chewing the nuts and slapping people with spot fines after a ban. In Myanmar, the government has ordered all employees not to chew betel during office hours and has started a campaign to remove betel vendors from public places, including those popular with tourists.

There’s some evidence that the push has had an effect. If a red betel nut grin historically was considered a symbol of beauty, that’s definitely not the case in Taiwan anymore, especially among younger urbanites.

‘I used to chew when I was working in a factory ten years ago. I did it because everybody else did,’ says a young man who offers his nickname, Hippo. ‘But I moved in to Taipei and here almost none of my friends use it. I will never touch it again. It’s dangerous and looks bad.’

From 2007 to 2013, Taiwan’s overall betel quid chewing rate among adult men fell by 45%, to around 950,000 people out of a population or almost 24 million, according to the Ministry of Health and Welfare.

Sales halve
In a roadside Taipei booth, Xiao Hui, a long-time seller, is busy preparing betel nuts while looking after her one-year-old daughter who is sitting behind her in a cot. Her index finger is brown from years of working with the nuts, and teeth dark red from chewing.

‘Even if the government says it’s not good for health and gives you cancer, many of my customers will come back. If you chew, you chew,’ she says. But she wants a different future for her three daughters.

‘I don’t want them to chew because it’s bad for their health. And I don’t want them to work as betel nut girls because it’s not a good job.’