What are the side effects of betelnut?

November 29, 2025 •

3 min read

Betel nut chewing is a practice engaged in by an estimated 600 million people worldwide, but modern research indicates it is highly unsafe. While many have underestimated the severe side effects of betelnut use, evidence clearly links it to various cancers and serious systemic health issues.

Quick Summary

Betel nut chewing carries significant health risks, including a high potential for addiction and various types of cancer. The practice also causes severe cardiovascular, oral, and reproductive damage, exacerbated by regular or long-term use.

Key Points

Carcinogenic Risk: Classified as a Group 1 human carcinogen, increasing the risk of oral, esophageal, and other cancers, even without tobacco.
Addiction Potential: The alkaloid arecoline creates a psychoactive effect leading to physical and psychological dependence with challenging withdrawal symptoms.
Oral Submucous Fibrosis (OSF): Chewing can cause this incurable precancerous condition, leading to mouth stiffness and difficulty eating.
Cardiovascular Damage: Long-term use is associated with a significantly higher risk of heart attack, stroke, and arterial stiffness.
Systemic Organ Failure: Toxic alkaloids can damage vital organs like the liver and kidneys, contributing to metabolic and digestive issues.
Compounded Risk with Tobacco: When combined with tobacco, the risks of cancer and cardiovascular disease are dramatically increased.
Reproductive Harm: Pregnant women who chew betel nut are at a higher risk of adverse outcomes, including low birth weight for their infants.

The widespread practice of chewing betel nut, often as part of a betel quid, has long been underestimated for its serious health consequences. The nut contains arecoline, a psychoactive alkaloid that produces stimulant effects but is also responsible for a range of dangerous physiological changes throughout the body. From immediate, noticeable reactions to devastating long-term diseases, the side effects of betelnut consumption affect almost every major organ system.

Immediate Side Effects

Even first-time or occasional users can experience a variety of physiological responses shortly after chewing betel nut. These effects are often sought by users but can be dangerous, especially for individuals with pre-existing health conditions.

Central Nervous System Stimulation: The arecoline in betel nut acts on the nervous system, leading to feelings of euphoria, increased alertness, and heightened stamina.
Cardiovascular Effects: Users often experience a rapid increase in heart rate (palpitations) and a rise in blood pressure.
Digestive Upset: Nausea, vomiting, abdominal colic, and diarrhea are common, particularly with larger amounts of betel nut.
Physical Reactions: Visible signs include sweating, flushing, and an increase in body temperature. The characteristic red saliva produced stains the mouth, lips, and teeth.
Dizziness and Tremors: Some users may experience tremors or dizziness.

Long-Term Health Consequences

With regular and prolonged use, the risks escalate from acute discomfort to life-threatening chronic conditions. The World Health Organization has classified areca nut as a Group 1 human carcinogen.

Oral and Dental Health Risks

Chewing betel nut is devastating to the oral cavity, leading to irreversible damage and increasing the risk of potentially malignant disorders and cancer.

Betel nut is a primary cause of oral squamous cell carcinoma. The risk increases with frequency and duration of chewing. Other oral health problems include oral submucous fibrosis (OSF), a precancerous condition causing mouth stiffness; periodontal disease leading to tooth loss; and permanent staining of teeth and gums.

Cardiovascular and Systemic Damage

Beyond oral health, betel nut's effects are systemic.

Regular consumption is linked to a greater risk of cardiovascular disease, including fatal coronary artery disease, heart attack, and stroke. Betel nut use is also associated with metabolic syndrome and type 2 diabetes. Its alkaloids can be toxic to the liver and kidneys, potentially leading to organ damage, and can worsen asthma symptoms. For pregnant women, chewing betel nut increases the risk of adverse outcomes like stillbirth, premature birth, and low birth weight.

Betel Nut Addiction and Withdrawal

Betel nut use can lead to addiction. Withdrawal symptoms can be severe and include cravings, irritability, anxiety, fatigue, dry mouth, mood swings, and sleep disturbances.

Betel Nut vs. Tobacco: A Comparison of Risks

Betel nut possesses severe dangers, which are exacerbated when combined with tobacco.

A comparison of risks between betel nut alone, betel nut with tobacco, and tobacco alone is detailed in {Link: PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC4080659/}.

Conclusion

Scientific evidence demonstrates that the side effects of betelnut are severe and far-reaching, from euphoria to potentially fatal cancers and cardiovascular events. Despite its cultural significance, betel nut is a toxic, addictive substance that poses a significant public health risk. For further information, refer to {Link: National Institutes of Health https://pmc.ncbi.nlm.nih.gov/articles/PMC4080659/}.

Frequently Asked Questions

The main addictive substance in betel nut is the alkaloid arecoline. Arecoline acts as a central nervous system stimulant, producing the feelings of euphoria and alertness that encourage habitual use and lead to physical dependence.

Yes, extensive research confirms that chewing betel nut on its own is a direct cause of cancer. The International Agency for Research on Cancer (IARC) has classified betel nut as a Group 1 human carcinogen, meaning it is carcinogenic to humans even without the addition of tobacco.

Early signs often include the characteristic reddish-brown staining of teeth, gum irritation, and increased salivation. Continued use can lead to more serious conditions like gum disease, mouth ulcers, and the first symptoms of oral submucous fibrosis, such as a burning sensation when eating spicy food.

Some of the damage, particularly the severe fibrosis associated with oral submucous fibrosis (OSF), is incurable and largely irreversible. While quitting can reduce future risk, permanent damage like teeth discoloration and significant gum issues often remain.

Betel nut chewing significantly increases the risk of cardiovascular disease. This is due to the effects of its alkaloids, which can cause increased heart rate, elevated blood pressure, arterial stiffness, and an overall greater likelihood of heart attack and stroke.

No, it is highly unsafe for pregnant women to chew betel nut. The alkaloids can negatively affect the fetus, increasing the risk of adverse outcomes including stillbirth, premature birth, and low birth weight.

Withdrawal symptoms for habitual users can be similar to those of nicotine withdrawal and include intense cravings, anxiety, irritability, dry mouth, fatigue, and difficulty concentrating.