Paan

Paan (Hindi: पान, Urdu: پان, Bengali: পান from Sanskrit parṇa, "পর্ণ" "leaf") is a preparation combining betel leaf with areca nut and sometimes also with tobacco. It is chewed for its stimulant and psychoactive effects. After chewing it is either spat out or swallowed. Paan has many variations. Slaked lime (chunnam) paste is commonly added to bind the leaves. Some South Asian preparations include katha paste or mukhwas to freshen the breath.

The origin and diffusion of paan (betel chewing) remains a somewhat unresolved issue since there is little unequivocal evidence to support the very early dates often quoted, though botanical evidence strongly suggests that the areca palm was not native to South Asia. Paan (under a variety of names) is also consumed in many other Asian countries and elsewhere in the world by some Asian emigrants, with or without tobacco. It is an addictive and euphoria-inducing formulation with adverse health effects.

The spit from chewing betel nuts, known as "buai pekpek" in Papua New Guinea, is often considered an eyesore. Because of this, many places have banned selling and chewing "buai".

The International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) accept the scientific evidence that chewing betel quids and areca nut is carcinogenic to humans. The main carcinogenic factor is believed to be areca nut. A recent study found that areca-nut paan with and without tobacco increased oral cancer risk by 9.9 and 8.4 times, respectively.

In one study (c. 1985), scientists linked malignant tumours to the site of skin or subcutaneous administration of aqueous extracts of paan in mice. In hamsters, forestomach carcinomas occurred after painting the cheek-pouch mucosa with aqueous extracts or implantation of a wax pellet containing powdered paan with tobacco into the cheek pouch; carcinomas occurred in the cheek pouch following implantation of the wax pellets. In human populations, they reported observing elevated frequencies of micronucleated cells in buccal mucosa of people who chew betel quid in the Philippines and India. The scientists also found that the proportion of micronucleated exfoliated cells is related to the site within the oral cavity where the paan is kept habitually and to the number of betel quids chewed per day. In related studies, the scientists reported that oral leukoplakia shows a strong association with habits of paan chewing in India. Some follow-up studies have shown malignant transformation of a proportion of leukoplakias. Oral submucous fibrosis and lichen planus, which are generally accepted to be precancerous conditions, appear to be related to the habit of chewing paan.

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