title: Areca (betel) nut chewing habit among high-school children in the Commonwealth of the Northern Mariana Islands (Micronesia).
abstract: OBJECTIVE
  To investigate the prevalence of its use by high-school children in Saipan in Micronesia. Usage of the areca nut is indigenous to south Asia and the western and south Pacific. Some serious health effects of areca nut chewing are recognized and the International Agency for Research on Cancer has recently classified regular use of areca nut as being carcinogenic to humans. Information on usage by young people, however, is scarce.
  
  
  METHODS
  Data on consumption of areca nut were obtained by a self-administered questionnaire. Following an oral mucosal examination using WHO criteria any detectable oral mucosal diseases were recorded.
  
  
  RESULTS
  Of 309 schoolchildren surveyed (mean age 16.3 +/- 1.5 years), 63.4% claimed regular use, the highest level recorded in any school population survey. Significant oral diseases detected were oral leukoplakia in 13% and oral submucous fibrosis in 8.8% of children.
  
  
  CONCLUSIONS
  These findings from Saipan suggest that areca nut chewing starts at a young age in Micronesia. As many users develop dependency this raises important concerns regarding its consequences for oral health.
authors.affiliation: Saipan Seventh-Day Adventist Clinic, Saipan.
authors.forename: Eric
authors.initials: E
authors.lastname: Oakley
authors.forename: L
authors.initials: L
authors.lastname: Demaine
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000293:Adolescent; D001114:Areca / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008849:Micronesia; D009061:Mouth Mucosa / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000523:psychology; D011795:Surveys and Questionnaires