Supari Use Among Urban Indian Youth: An Unreported Epidemic?

Introduction: Supari, also known as areca nut or betel nut, is a commonly-chewed product available in India (either on its own, or with tobacco products). Endemic across the Indian subcontinent, supari is low-cost (as little as one rupee or $0.02USD per packet) and socially acceptable. Despite its popularity, supari is a known carcinogen and may act as a gateway product for smokeless tobacco use.

Methods: 1533 students in the 7^th, 8^th, and 9^th grades (ages 10-18) were surveyed in 32 randomly selected public schools participating in anti-tobacco NGO programs in Mumbai, India in September 2013. Students were asked about current supari use, and perceptions of harm associated with supari. The results were analyzed using SPSS.

Results: Among students, 23.3% (n=260) reported using supari within the last 30 days. Supari use was more frequently reported by male students (29.9%, n=176) compared to female students (16.0%, n=84), and prevalence increased with age 14.7% (n=21) of 12-year olds reported supari use, compared to 30.0% (n=19) of 16-year olds). Only a small proportion of students identified supari as a harmful product (12.5%, n=180).

Discussion: The results of this study indicate that supari is commonly used by school-aged youth in Mumbai, India. Awareness of the health effects of supari use was low among the surveyed students. Given the negative health effects of supari, greater attention and efforts to control supari use among children and youth, including education campaigns and bans on bright packaging and the use of pop culture icons, should be enacted.