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  Table of Contents  
Year : 2015  |  Volume : 52  |  Issue : 1  |  Page : 138

Display of health-risk warning on “arecanut sachets”

1 Department of Public Health Dentistry, FODS, CSMMU (Upgrade KGMC), Lucknow, Uttar Pradesh, India
2 Department of Paediatric and Preventive Dentistry, FODS, CSMMU (Upgrade KGMC), Lucknow, Uttar Pradesh, India

Date of Web Publication3-Feb-2016

Correspondence Address:
V K Gupta
Department of Public Health Dentistry, FODS, CSMMU (Upgrade KGMC), Lucknow, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-509X.175571

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How to cite this article:
Gupta V K, Malhotra S. Display of health-risk warning on “arecanut sachets”. Indian J Cancer 2015;52:138

How to cite this URL:
Gupta V K, Malhotra S. Display of health-risk warning on “arecanut sachets”. Indian J Cancer [serial online] 2015 [cited 2022 May 17];52:138. Available from:


It is a universally accepted fact that “children are the world's most valuable asset and its best hope for the future”. There is also a saying that “a child learns to explore the world through his mouth.” Use of arecanut (meethi supari) results in restricted mouth opening. Meethi supari, a mixture of arecanut, sugar, and flavor is easily available in market and at neighborhood shops. Consumption of meethi supari at very early age is very common in South East Asian children.

Oral submucous fibrosis (OSMF), a precancerous condition in very young children is associated with chewing areca nut. [1],[2] OSMF is commonly seen in lower socio-economic group children. This issue needs to be urgently addressed. OSMF creates potential for malignancy and is life threatening and needs to be treated by a specialist, making the management of OSMF expensive. OSMF can be prevented and controlled to a large extent by giving health education and motivation to children, parents and school teachers. It is therefore essential that to combat OSMF a preventive approach, with focus on health education and promotion, be of prime importance.

There is a myth amongst public and even Government that the use of arecanut is not detrimental to health which has consequently led to its abuse to an extent that it is taken by children who have a desire to have anything sweet. Arecanut consumption by young children at early age acts as the “stepping stone” to smokeless tobacco consumption. Furthermore, tobacco is considered to be a “gateway drug” which may lead to use of alcohol, marijuana, and other harmful illegal drugs. This is the sequence most of the time with the main culprit being “arecanut use” at a very early age (6-12 years).[3],[4],[5],[6] Also, research has comprehensively established that arecanut is a potential carcinogen.

Government policy on warning sign on supari is always vague. It is ironical that the High Court of Karnataka has recently ruled that chewing of arecanut or supari is not injurious to health and that arecanut products need not carry the warning.[7]

The warning on arecanut sachets is in very small-sized print (hardly readable) and vague with no pictures (without mention of specific health risks). Furthermore, warning is printed in English (not in local language) and on the back side of sachet which is hardly effective. For warning about health risk of arecanut to be effective, the same should be printed on arecanut sachets the way the warning is printed on sachets/packs of other tobacco products.

Warning label on tobacco products should cover at least 30% and preferably 50% of principal pack display areas; be large, clear, visible, and legible, and not make use of misleading terms (e.g., “light” or “mild”).[8] Various studies have shown that if strong warning label is placed in front and top of the principal pack display areas of tobacco product, it makes a more deep and significant effect.

The problem of oral cancer is dealt with under national cancer control program. Now-a-days, children are using arecanut, its products and tobacco at very early age and Government is not targeting this age group.

Epidemiologists and researchers should also target school children and lower socio-economic group children for their consumption of arecanut and its products and spread awareness amongst the children about ill effects of their use on their health. It is also suggested that pediatric dentists, pediatricians, health professionals and oral health professionals should advise children not to consume supari, as its use is as harmful as any other tobacco product.

  References Top

Maher R, Lee AJ, Warnakulasuriya KA, Lewis JA, Johnson NW. Role of areca nut in the causation of oral submucosal fibrosis: A case-control study in Pakistan. J oral Pathol Med 1994;23:65-9.  Back to cited text no. 1
Secretan B, Straif K, Baan R, Grosse Y, El Ghissassi F, Bouvard V, et al. A review of human carcinogens–Part E: Tobacco, areca nut, alcohol, coal smoke, and salted fish. The Lancet Oncology 2009;10:1033-4.  Back to cited text no. 2
Dhariwal R, Ray JG, Pattanayak SM, Swain N. Oral submucous fibrosis: A report of two pediatric cases and a brief review. J Indian Soc Pedod Prev Dent 2012;30:85-8.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
Ahmad MS, Ali SA, Ali AS, Chaubey KK. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar. J Indian Soc Pedod Prev Dent 2006;24:84-9.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
Shah B, Lewis MAO, Bedi R. Oral submucous fibrosis in a 11-year-old Bangladeshi girl living in the United Kingdom. Br Dent J 2001;191:3.  Back to cited text no. 5
Yusuf H, Yong SL. Oral submucous fibrosis in a 12-year-old Bangladeshi boy: A case report and review of literature. Int J Paediatr Dent 2002;12:271-6.  Back to cited text no. 6
WHO report on the global tobacco epidemic 2011-Warning about the dangers of tobacco, p. 14. Available from: [Last accessed on 2012 Jun 25].  Back to cited text no. 8

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