title: Paan and Gutka in the United States: an emerging threat.
abstract: Smokeless tobacco and areca nut usage are integral cultural traditions in South Asia. Paan and gutka are two commonly used products which contain these ingredients. They are immensely popular in South Asia and with South Asian immigrants. Regular paan and gutka use is associated with several deleterious health consequences, most significantly oral cancer. Of particular concern is the markedly increased risk of oral cancer in South Asian immigrants when compared with the natives in new areas of settlement. The South Asian community in the United States is large and rapidly growing. Paan and gutka are legal in the United States, and readily available in ethnic enclaves. Smokeless tobacco prevention and cessation research and interventions have not yet addressed the unique sociocultural circumstances of this growing, at-risk community. The medical, dental, and public health communities need to join forces to combat this emerging threat.
authors.affiliation: Center for Immigrant Health, New York University School of Medicine, New York, New York 10016, USA. Jyotsna@med.nyu.edu
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Changrani
authors.forename: Francesca
authors.initials: F
authors.lastname: Gany
mesh_terms: D001114:Areca / Q000009:adverse effects*; D001210:Asia, Southeastern / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology*; D003466:Cultural Characteristics; D004641:Emigration and Immigration; D006266:Health Education / Q000592:standards; D006801:Humans; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology*; D011322:Primary Prevention / Q000592:standards*; D012307:Risk Factors; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology