Prevalence, age of onset and demographic relationships of different areca nut habits amongst children in Tower Hamlets, London

Objective To examine prevalence and demographic relationships of different areca nut habits amongst children. Design Self-administered questionnaire. Subjects Children aged between 11 and 15. Of 800 questionnaires distributed, 704 were fully completed (88%). Setting Two secondary schools in the London district of Tower Hamlets. Measures Demographic, areca nut habits used, age first used, still using, frequency of use. Results Users of any areca nut habit were exclusively from the South Asian population. Of this population, 77% had engaged in a habit, and dependent upon habit between 54 and 92% of these still remained current users. The highest prevalence of current use for boys and girls respectively was for areca nut alone (36%, 43%), followed by mistee pan (35%, 29%), betel-quid (27%, 26%) and pan masala (14%, 16%). Of the current users, 44% engaged in one habit only, 24% two, 20% three and 13% all four. The highest period of risk for starting to use areca nut alone, betel-quid and mistee pan was between ages 5 and 12, whilst for pan masala it was after 10. Boys had a significantly higher risk of beginning use before 10 (P <.001) and a higher frequency of use for pan masala (P < .01), areca nut alone (P < .05) and betel-quid (P = .06) than girls. The frequency of using each habit was between 3 and 5 episodes per week, however boys use pan masala approximately 10 times per week. Conclusion South Asian children may already be experienced users of areca nut. Greater attention should be directed towards identifying signs of oral submucous fibrosis, oral cancer and other potentially malignant lesions within the South Asian population.