Warning to Capital's Asians on cancer risk of chewing tobacco

Many users of the traditional tobacco product, known as paan, are unaware that chewing it can lead to oral cancer.

The Minority Ethnic Health Inclusion (MEHI) project has now been given 7500 to come up with a strategy to help deter its use.

Female members of the Lothians' 700-strong Bangladeshi community are particularly avid users, although paan use is common among all South Asian communities.

And users themselves have backed the campaign, saying it could persuade members of the community who use the drug to kick the habit.

Paan is a green leaf. Users spread a lime paste called kapha and a variety of spices and ground nuts on the leaf, including the betel nut which is distantly related to cocaine.

The spices, known as supari, can be bought ready mixed at many Asian-run grocer shops in the Capital.

The ingredients are also sometimes sold separately and prepared by users before they make up the paan parcel.

Shredded tobacco is often then added to the mixture and the paan leaf folded in such a way that the spices will stay within the package when it is put in the mouth.

Users either suck or chew the paan and the spices can stain the mouth red. Many users do not realise that they will become addicted to the tobacco and their habit could lead to oral cancer.

Smita Grant, project manager at MEHI, said the group hoped to use the money to develop an information pack for paan users and health professionals.

Often health workers do not know about paan and so cannot offer advice on its effects or where users can seek advice to quit.

Ms Grant said: "We have done some work already with a group of Bangladeshi women and found that people were not aware it was bad for them.

"You can easily buy paan and people will make it after meals and at special events like weddings or at social gatherings. They see it as part of their culture so do not realise there is a problem with it."

Paan chewer Labas Miah said he thought the campaign would encourage people to give up. Mr Miah, a chef at Verandah Restaurant on Gorgie Road, said: "It has been in our tradition for so long. Old people chew it a lot and children pick up on that. My mother used to chew all the time, and that's how I started.

"I think a campaign making people aware of the dangers will have a great effect - it will make me think twice about it."

Ms Grant said that even pregnant women chew paan, oblivious to the harmful effects of both the tobacco and the betel nut.

Naina Minhas of the women's welfare group Nari Kalyan Shango (NKS) confirmed that paan chewing is common among Bangladeshi women.

Currently, a group of 15 women meet each week to learn of the health consequences of paan and ways to it give up.

Mrs Minhas said: "In South Asian countries, where betel grows, paan is very acceptable. It's a very traditional thing. Smoking and drinking are not acceptable, but paan chewing is."

Funding for the project has come from anti-tobacco group ASH Scotland.

Chief executive Maureen Moore said: "We think it's important that people are given information so they can make an informed choice."

THE FACTS

MOUTH cancer can occur in any part of the mouth, tongue, lips and throat.

The Mouth Cancer Foundation says that mouth cancers have a higher proportion of deaths per number of cases than breast cancer, cervical cancer or skin melanoma.

In recent years, there has been a 19 per cent increase in cases, with an increasing number of young people being affected.

The mortality rate is just over 50 per cent, despite treatment, with about 1592 deaths per year in the UK, mainly because of late detection.

Symptoms of mouth cancer include difficulty in chewing or swallowing, a chronic sore throat or hoarse voice that does not heal and red or white patches in the mouth or on the tongue.