The Leaves of a Vine

By Chuah Siew Yen

Royalty to Peasantry, Weddings to Funerals: A Millennia-old Habit

The leaves of a vine, the nut of a palm, with a slather of calcium hydroxide paste – this magical combination of the betel quid has excited and intoxicated royalty and peasantry since antiquity.

Image source: Betel Chewing in South-East Asia by Dawn F. Rooney; accessible at:

The relaxing and alerting effects of the quid exudes a general sense of heightened well-being more intense than caffeine or nicotine. Is it any wonder then that the chewing habit spread to the western Pacific, across the Indian subcontinent, reaching as far as the fringes of East Africa to Madagascar in the west; Melanesia to the Santa Cruz Islands in the east; southern China in the north, and Papua New Guinea in the south?

The World Health Organisation (WHO) estimates that globally 600 million people today still indulge in betel chewing, also known as chewing betel quid. This translates to one-tenth of the human race, and is recognisable by the ubiquitous red-stained lips and reddish-blackened teeth of the users. The custom pervades Asia, has no gender barriers and embraces all ages and classes.

The essential ingredients of the quid are the betel leaf which has a fresh, peppery taste (though some varieties may be bitter-sweet), the areca nut with its tannin, oil gum and nicotine/arecoline properties, and slated lime which increases the alkalinity in the mouth of the chewer to release the alkaloids, the active ingredients in the nut. Tobacco and other spices such as clove, cumin, and cinnamon, may be added for flavour. Chewing the quid thus produces the signature red spittle.

A betel nut chewer in Papua New Guinea. Image source: Photograph by David Longstreath for the Associated Press (AP)

The chewed preparation is not swallowed. Profuse spittle is produced during the chewing and the excess has to be spat out. This constant spitting is an inevitable part of quid-chewing. Spitting the excess juices in public spaces is not only repulsive and nauseating, but unhygienic. The near permanent red stains left on floors, roads and walls are an eyesore and defaces the environment.

Paan (betel quid) made with areca nut, betel leaves and lime, with or without tobacco, causes profuse red coloured salivation. This saliva is spat, yielding stains and biological waste pollution in public spaces. Many countries and municipalities now have laws to prevent paan spit. Image source: Photograph by Anna Frodesiak; CC0.

When quid chewing spread and was elevated to a higher social practice, the spittle was disposed of into special receptacles now known as spittoons. This later gave rise to an entire artistic genre that included implements for preparing, serving, transporting, and storing betel ingredients. Boxes of various sizes to hold smaller containers of the areca nut, lime and spices were made from wood or lacquer which were initially plain but later decorated. For the aristocrats and royalty these containers could be of silver or gold. As the practice grew in sophistication, a small knife, spatula, and scissors/cutter were added in the box. To complete the kit the tray of containers is placed on a matching spittoon. See picture below. In the Malay language it is ‘tempat/tepak sirih’.

Ingredients found in the individual vessels called cembul of the tepak sirih. Traditionally, each item is positioned according to a particular order. Image source: Perpustakaan Negara Malaysia (PNM); accessible at:

Tepak sirih > Betel quid set
Kepala tepak > Front of tray/set
Ekor tepak > Back of tray/set
Pinang > Areca nut
Kapur > Lime
Gambir > Gambier
Tembakau > Tobacco
Cengkih > Clove
Daun sirih > Betel leaf
Kacip > Cutter/slicer for areca nut

Peranakan tempat sirih, wood, mother of pearl, silver and gold plating, early 20th century, Intan Museum. Image source: Photograph by Haa900; CC0.

The materials and craftsmanship of a betel nut set (tepak sirih) indicates a person’s wealth and status. Only royalty and elites possessed quality metal or porcelain sets and tools while a commoner had access to only wooden ones.

In the past in India and Sri Lanka, it was a custom of the royalty to chew area nut with betel leaf. Kings had special attendants whose duty it was to carry the betel box wherever the king went, and to ensure the ingredients made for a good chewing session.

The origins of betel chewing are unknown although it has long been held that betel chewing is native to India, dating back to Vedic times. According to ancient books of Ayurveda, the practice of chewing betel leaves (not the quid) after meals was common between 75 and 300 CE, for its curative properties.

In Chinese folk medicine betel leaves have been used for detoxification and anti-mutation. There are research experiments where the leaf extract and purified compounds are anti-diabetic and anti-inflammatory. The various Ayurvedic medicine uses for the leaf are as a diuretic, for intestinal ailments and protection from infections.

Despite the widespread use of betel leaves in ancient times, there has not been strong evidence of incidence of oral cancer. Various experiments evaluating the effects of betel leaves suggested no harmful effect when consumed alone. (Bhide et al.)

On its own, betel leaves were used as a stimulant, antiseptic and breath-freshener whereas the areca nut was considered as aphrodisiac. It is again not known when and where these two different stimulants were first put together, but there is archaeological evidence that the leaves and nut were chewed together from very ancient times. References to betel chewing appeared in ancient Greek, Sanskrit and Chinese literature as early as 100 BCE.

It is believed the practice of betel nut chewing originated from Island Southeast Asia where the plant ingredients are native. The oldest evidence of betel nut chewing is found in a burial pit in the Duyong Cave site in Pahlawan, Philippines. The dentition of several skeletons in the pit is stained, typical of betel chewers. One of the anadara shells used as lime containers still had traces of lime. Burial sites in Bohol dated around first millennium CE also had skulls with the distinctive reddish stain characteristic of betel chewing, in the oral cavity.

Areca catechu illustrated by Francisco Manuel Blanco in Flora de Filipinas (1880-1883). It is originally native to the Philippines. Image source: Plate from book; accessible at:

The Areca palm and the heart-shaped betel leaf from the vine of the sub-tropical pan plant were endemic in these areas from where betel chewing probably spread during the Austronesian expansion. The most concentrated areas for betel chewing were the areas where the climate and soil are suitable for the cultivation of the nut and leaf, and where there is an adequate source of lime.

The habitual usage of the betel leaf-nut-lime combination spread from the Philippines to Taiwan and onwards to the rest of Austronesia and neighbouring cultures through trade and migration. Its use was documented by ancient historians in Ceylon and Persia around 600 BCE and parts of the Arab world by the 8th and 9th centuries. It is believed that betel was brought to Europe by Marco Polo around 1300 CE.

Even though the narcotic and stimulating effects of betel chewing had been noticed by travellers and botanists of the 16th century, it was not until the 19th century that attempts were made to study them scientifically.

Through maritime trade through the centuries, the leaf, nut and use of sirih (leaf) and pinang (areca nut) spread from east to west, influencing daily life and rituals from marriages to funerals… and it isn’t limited to ordinary folk; even royalty was in on it! The use of this humble quid eventually became embedded in social convention and court ceremony. The quid became the token of favour in village courtships as well as in royal courts.

Tepak sirih set from Hani’s personal collection. This is a typical presentation to offer guests. Fresh flowers and cinnamon sticks are used to decorate the tray. Photograph by author.

The habit caught on naturally as ingredients were freely traded, available, affordable and … addictive! Synonymous in Myanmar with hospitality and social enjoyment, almost everyone during the past century used to own a betel box as men, women and monks of all ages and ranks chewed betel.

This is clear indication of man’s innate desire to seek temporal solace in stimulants, be they royalty, peasantry, or clergy. Kings, emperors, sultans, emirs – all display hedonistic behaviour, their wealth allowing them to indulge insatiable hunger for things pleasurable.

In 990 CE, a Chinese envoy recorded cultural uses of betel chewing by a Vietnamese king, and by the 17th century, western travellers recorded the phenomenon as a deep-rooted social ritual. Since the 11th century, the royal use of betel in Southeast Asia is described in written records which provide details about the protocol of sharing a quid with a king and the use of betel in royal ceremonies. From the 16th century when Europeans reached the East, they viewed this alien foreign custom as ‘…unhygienic, vile and disgusting…’

Chewing habits of people may have changed, but having been around so long it remains an inalienable part of cultural and religious rituals. Whether medicinal, magical, symbolic, or social, the betel serves a purpose in many cultures, encompassing more than just ritual chewing. From its historical use as medicine, it has evolved to feature symbolically in many important social and religious ceremonies.

Across the Asian region, betel has a strong association with engagements and marriages. In mainland Southeast Asia, the betel nut symbolises love and faithfulness. A decorated betel nut set is featured at traditional weddings and betel nuts are offered as dowries. Sirih, the Malay word for betel leaf, means ‘a young girl who is of marriageable age’, while the word for the areca nut, pinang, can mean ‘to court’ or ‘to propose’. In Sumatra, a Batak man will offer a betel quid to start a conversation with his potential wife, while an Iban woman will take betel from a man if she accepts his marriage proposal.
There was a custom for lovers to chew the areca nut and betel leaf together for its breath-freshening and relaxant properties. Thus, a sexual symbolism came to be attached to the chewing of the nut and leaf, the nut representing the male, and the leaf the female.

On the other end of the spectrum, betel is featured in funeral rites as it is believed to pave the way to a better incarnation. Cambodian-Khmer cultures place a betel leaf together with an inscribed Buddhist verse between the lips of the deceased. In northern India relatives offer their final farewells by placing betel on the dead body. In Luzon Island, betel juice was used to embalm the dead as far back as the 16th century. Because of cross-cultural interactions, many of these rituals overlap across communities.

In between life and death ceremonies, the betel is a significant item in childbirth in several Asian communities. After childbirth, mothers undergo a ritual ‘lying by the fire’ to dry out the womb while offering protective spirits a platter of betel, flowers, candles, and incense. The areca flower is added to the mother’s bath for curative effects on the womb. The baby is laid on a bed of areca nut palms, to symbolise prosperity.

Considered an auspicious ingredient in Hinduism and some schools of Buddhism, the areca nut and betel leaf is still used in religious ceremonies, and honouring individuals at festivals.

Preparing betel quid for sale in Calcutta. Image source:

The practice lives on today in Oceania, many South, East and West Asian countries, and India. In some parts of Asia these psychoactive parcels are still used as a herbal remedy for anything from toothache, indigestion to acne, as well as in veterinary and ayurvedic medicine. Some others believe they have aphrodisiac properties.

Today, the betel habit has declined in popularity, especially in urban areas where quid chewing is frowned upon because of the unsightly splashes of crimson on walls and roadside left by indiscriminate chewers. Modernisation with education has taken over. To many urban youths it is a memory of the past.

But to agrarian communities and rural areas where socio-cultural traditions are so strong the habit is hard to break. Low health literacy is another contributing factor. Quid chewing remains an ingrained habit among working-age men who chew to stay awake during the long hours at work at construction sites, fishing at sea or long-distance driving. The stubborn users seem oblivious that the habit is a deadly addiction as the ingredients in a betel quid are cancer-causing agents and stimulants, and a major cause of oral and laryngeal cancers.

Ni Ni Wah puts a betel quid in her mouth. She dismisses the risks of cancer saying “mouth cancer happens to people who keep betel quids in their mouth all night while they sleep.” Image source: Photograph by Dave Grunebaum for VOA.

Taiwan has made progress toward reducing quid use by implementing numerous government-funded programmes. Nation-wide educational outreach, cessation courses and incentives for cultivating alternative cash crops adopted since the 1990s has resulted in a notable reduction in the number of quid users, but the issue is far from resolved. The betel-nut trade in Taiwan has been widely sexualised: young scantily-clad maidens still hawk the product from transparent cubicles along highways.

Half of Papua New Guinea’s 9 million people are quid chewers – that’s big betel business! This country has the world’s highest oral cancer mortality. In 2013 physicians and public health officials managed to get lawmakers to pass an outright ban on selling and chewing quid in Port Moresby but the success was short-lived. Those protecting their trade protested strongly… and the sale was subsequently allowed in designated areas. Local experts predict that the burden of oral cancer will continue to worsen.

It remains legal to sell an addictive carcinogen without a warning label in much of the world. Policy makers in these regions have continually neglected to adopt public health initiatives to address production and use of betel quid.     

The medical community is stuck on the outside, looking in, as an unregulated industry fuels a health disaster. It is a reminder of how little progress has been made towards addressing health disparities between privileged and marginalised populations.

Note: This article is inspired by the presentation on Betel Chewing – Mythology, Legend, Fable & Folk Tale by Krishnan Karruppan to Museum Volunteers on 2 November 2022.

Edited by Meredith Tomkovitch


1. Dawn, F. Rooney, Betel Chewing Traditions in South-East Asia (Kuala Lumpur: Oxford University Press, 1993), 1. (Call no. RSEA 394.14 ROO-[CUS])
2. “The Epicurean, Palliative Pleasures of Paan,” Himalayan Academy. Publications, published 1 February 1994.


Author: Museum Volunteers, JMM

Museum Volunteers, JMM Taking the Mystery out of History

%d bloggers like this: