Cancer Researchers to Survey Use of Paan and Bidis
India West, News Report, Michel W. Potts, Posted: Sep 05, 2003
LOS ANGELES -- It has long been known from previous research that chewing paan or betel leaf with tobacco is carcinogenic. A new study by the International Agency for Research on Cancer has concluded that chewing paan without tobacco can also potentially cause cancer.
Paan, a leaf popularly eaten after meals as a digestive in South Asia, was being sold at booths during the India Independence Day celebrations here last month, and researchers are concerned that its use and the link to cancer is not properly understood by the Indian American population.
As a result, a consortium of health investigators from the University of California at Los Angeles, the Santa Clara County Public Health Department, and the South Asian Network have joined forces to conduct the "California Asian Indian Tobacco Survey." Funded by the Tobacco Control section of the California Department of Health Services, the survey intends to determine the prevalent use of tobacco and paan through a random sampling of Indian American men and women throughout California.
The use of paan with tobacco can cause oral cancer, cancer of the pharynx, and cancer of the esophagus, researchers have said. The use of paan without tobacco but with a betelnut mixture has now been found to cause oral submucous fibrosis, a precancerous lesion that can progress to oral cancer,according to the recent study.
In addition to chewing paan, Indian Americans also smoke bidis which are small brown hand-rolled cigarettes where the tobacco is wrapped in a leaf. "We're trying to determine what percentage of that population is" doing so, Hozafa A. Divan, a co-principal investigator with the Santa Clara County Department of Health, told India-West.
The projected two-month long study will begin in October, and the information extrapolated from the findings will be used to develop various local and statewide strategies to improve the health of California Indian Americans. "We're hoping to enroll about 3,000 survey respondents," Divan said, "and we hope to have some preliminary information available by this time next year."
The survey will be conducted by telephone, and while the focus is on the use of paan, questions will be drawn from the California Adult Tobacco Survey, including questions about current use, past use and attempts at quitting smoking by those who smoke cigarettes and bidis regularly.
The computer-assisted telephone interviews will be used to collect a random sampling of paan and bidi use by the respondents, but only the interview data will be recorded. Respondents' names will not be recorded in order to protect their confidentiality.
Cultural questions will also be asked during the survey, and if the data shows a high smoking rate among second-generation Indian Americans, "then we can initiate programs about the harmful effects of smoking and have health education programs that are more culturally appropriate," Divan explained to India-West. For more than 30 years, cigarettes sold over the counter in the U.S. have carried the Surgeon General's warning that cigarette smoking has been shown to cause cancer. If the data from the survey shows an extensive use of paan and bidis, similar warnings may be posted on those products.
The survey results "could help policy makers and lawmakers to make that determination as to whether of not it is important to do so," Divan noted.
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