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It is sweet. It is tasty. It is inexpensive. And it is also highly addictive! Easily available in attractive looking packets, sweet supari (betel nut) and gutka (a mixture of betel nut, katha, lime or chuna, tobacco and food fragrances), are favourite mouth fresheners for a lot of children and adults.
School children often offer the packets to each other in lieu of candy, but most of them do not know that these harmless looking sachets are very harmful for them and can play havoc with their oral and general health. Gutka is a more dangerous form, because to get its consumers hooked, it often contains traces of tobacco. The betel nut used is usually of very poor quality, sometimes infested with fungus and microscopic insects and unfit for human consumption. The greedy manufacturers add sweeteners and food colours to make this substandard supari attractive and palatable, totally disregarding the fact that these are additional health hazards for the consumers.
Although sweet supari and gutka are popular among all age groups and consumed by members of all social classes, the habit to use them as a perfect end to a snack or a meal, is usually cultivated during the school days. The intake usually begins with munching a pack or two a day. Gradually the quantity increases as children find themselves habituated to it. And then the craving sets in!
Some people find themselves totally helpless, as they cannot concentrate or feel comfortable until a pocketful of this sweet poison is buried in their cheeks or tucked under their tongue.
Smoking is still considered a complete no-no for children and as long as they can, parents take great care to make sure that their kids do not take up this habit. Cigarette manufacturers are bound by the government to print warning notes on their packs. But sadly, there is no such rule for sweet supari and gutka. Usually we see that parents are not so particular about restricting their children’s intake of these harmful substances, because neither the parents nor the children realise that these can be as dangerous as smoking. As there is a total lack of awareness of their harmful impact on health, the usage is ever increasing.
Dr Sadaf Ahmed says, “Sweetened supari contains a chemical substance called arecoline which causes inflammation of the gums. Initially, ulcers are formed in the mouth progressing to a disease called ‘oral submucous fibrosis’ or OSF (in easier terms ‘the inability to open the mouth fully’). This in turn leads to nutritional deficiencies because impaired jaw movement affects the diet intake of children, making them physically weak and more prone to infections. The teeth become more sensitive to spicy foods and the tongue and gums often give a burning sensation.”
Dr Ayesha Khan, also warns by painting a gloomy picture, “Direct and repeated contacts of the gums with supari cause them to recede which in turn loosen the teeth. Increase in mouth ulcers and rotting of the gums is also caused by betel nut chewing. In addition to oral submucous fibrosis (OSF), in extreme cases long-term usage can cause cancer of the mouth (including the lip, tongue and cheek) and throat, because betel nut or supari is a known human carcinogen (cancer-causing agent).”

According to the WHO, chewing supari leads to cancer of the mouth even if tobacco is not added to it. In countries where betel nut is consumed extensively, there is a much higher level of oral cancer.There is a dire need to initiate a drive against this sweet poison. To save our oral and general health, children you need to be aware of the harmful effects of these easily available packets of sweet supari and gutka. Newspapers and the electronic media can play a significant role by signalling out appropriate health messages, teaching the public what harm can be caused by sweet supari and gutka, and working for a ban on their sale to children.
Sadly, at present the situation is totally otherwise. Instead of discouraging the sale of these harmful sachets, we often see unrealistic ads of sweet supari on the television. Attractively arranged on a silver platter, a glamorous hostess is seen serving them with a flourish to her guests, or a macho man seems to drive his strength from them, fighting his opponents and making them flee after munching a packet. Children, who are easily influenced by these ads, are hoodwinked and attracted into buying them.
Dr Sadaf says, “During my internship, I have observed many school going children coming to the OPD with problems related to supari and gutka intake. Unfortunately, visits to the dentists in our country are not too frequent, so the initial symptoms of OSF are not so obvious. Usually, patients come in the third stage of the disease and then the treatment option is usually only surgical. These patients are advised not to continue chewing of supari (areca nut) and warned that the next stage is of oral cancer which has more severe treatment modalities. So the first step towards saving our children from this dangerous junk is to create awareness of the consequences of having sweet supari and gutka. They must also be taught the importance of regular dental checkups, a healthy diet and also to maintain a good oral hygiene.”
Dr Khan adds, “Apart from health problems, sweet supari and gutka have bad cosmetic effects as the food colours added to them cause discolouration of teeth. Being as addictive as nicotine and caffeine, they cause dependence and on discontinuation of usage uncomfortable withdrawal effects.”
Dr Anwar Alam of Internal Medicine at AbbasiShaheedHospital corroborates this. “The reason behind the surge in oral diseases in the past decade in the younger people is the rampant use of gutka and gutka became this popular because it was easily available everywhere and it was convenient to use.
Similarly, there is social stigma attached to tobacco smoking of women so they may not take up smoking that readily or even if they do take it up, they do not do it as openly as men do. However, gutka consumption is free of all the prejudices and inconveniences. It is as easy to carry as a small candy, it is not messy, it is fragrant, one does not need to go to a paanwala exclusively to buy it, it has no social stigma attached to it and hence can be consumed by teenage girls and adolescent boys. What most people do not know is that its health risks are just as injurious, if not more, as that of chewing or smoking tobacco.
According to a research, apart from the urban centers, gutka usage is as popular, if not more, in rural attachments to the city. The newly built 48 kilometers long road that connects Karachi to Mubarak Village is dotted with various small villages, inhabited by fishermen and their families. Every village has its own small shop and they may or may not stock basics such as milk or onions but almost every shop sell packaged and unpackaged gutka which is the perhaps the most popular item. Tahira Kaukab, program officer of a local NGO Indus Earth that works in the area stated that people in this area may go without food but will not forego their gutka addiction. She further added that the gutka sold in the coastal belts is often expired and they have found small insects and parasites in the gutka packets.

So friends, Beware of this killer! And the greedy manufacturers who are marketing it at the cost of your health. A few moments of a sweet sensation in your mouth could cost you and your loved ones a life time trauma!