Pacific Family Health Journal with Dr Rodney Itaki
Betel Nut Law Can Help Control Mouth Cancer in PNG
A lot of people reading this article will say – “betel nut chewing is part of our culture. Why do we need a law to control our own culture?” And I agree with all who say this. But the buying and selling of betel nut in our major urban centres is causing a lot of social problems and we have to explore ways how best we can allow people to continue to enjoy their favourite nut without the social problems associated with commercial side of betel nut.
The social problems of betel nut chewing appear to be predominantly in the urban centres in PNG with a few exceptions. We already know that betel nut chewing leads directly to mouth cancer. I don’t think there is only one solution to these problems. We should explore other ways to attack the problem from different angles.
I see 3 main factors that are contributing to the social problems associated with betel nut chewing.
Betel nut chewing is a cultural practice in the coastal areas. It was never a cultural practice in the highlands provinces. Introduction of betel nut chewing into the highland provinces has resulted in the habit to flourish outside the context and significance of which betel nut is traditionally chewed. Also it is common belief among some provinces in PNG that betel nut husk and spit can be used by sorcerers to cast spells on the chewer so betel nut chewers in these areas do not throw betel husk nor spit in public places. The same cannot be said of provinces in which betel nut chewing is an introduced practice – the highlands provinces.
The second contributing factor is the commercial aspect of betel nut chewing. Betel nut generates a lot of money for those involved in the business. With the ever increasing cost of goods and services in PNG, more and more people and families will get into the betel nut business, whether it is small scale (e.g. selling betel nut in front of your house) or selling in bulk.
The selling is flourishing because there is a demand for the nut. In other words, the selling will stop or slow down if the demand for betel nut also stop or slow down. It is simple economics – the selling is being driven by the buying.
So these 3 areas need to be targeted to control the habit of betel nut chewing in urban PNG and indirectly reducing mouth cancer rates. This is only my opinion and I welcome comments for discussion.
The Federated States of Micronesia (Pohnpei State), Palau and Marshall Islands are few of the Pacific Island Countries that have betel nut laws to control the habit of betel nut chewing. Betel nut chewing is now established as a carcinogen by the World Health Organization so like all other cancer causing agents/habits, there should specific laws in countries that this habit is widespread.
So can laws targeted at controlling the habit of betel nut chewing prevent and control the habit? And indirectly control the social problems and unhygienic scenes observed in PNG?
Betel nut is widely chewed in Pohnpei (one of the States of FSM) but the streets are clean and there are very few red betel nut stains. Ponhpei introduced the Betel Nut Prohibition Act 2010 to control this habit. The Act prohibits the chewing of betel nut in shops, offices, public areas, parks and spitting of the quid in public places. Offenders are fined or sometimes required to do community service.
The Act also mandates shops, private and public institutions to put up notices on the walls or doors to inform the public of the prohibition and the penalty if caught. Betel nut is sold in shops in neatly packed packages. Street hustling to sell betel nut is prohibited. Palau and Marshall Islands also have similar Betel Nut Prohibition Laws.
Similar laws ought to be introduced in PNG! Call it Buai Prohibition Act or something similar specific for controlling the sale and buying of betel nut in the urban areas of PNG.
Dr Rodney Itaki, MBBS, BMedSci
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