Carcinogenic Alkaloids Present in Areca Nut

Abstract

Areca nut (AN) and tobacco are widely consumed across the world by ~600 million and 1.3 billion people due to their addictive properties, respectively. Globally, AN is the fourth most common psychoactive substance after caffeine, nicotine, and alcohol. It is not only a psychostimulant and addictive substance, but also a potential carcinogen as per World Health Organization (WHO)-International Agency for Research on Cancer (IARC). There are four major alkaloids present in the areca nut, namely arecoline, arecaidine, guvacine, and guvacoline. Arecoline is the major alkaloid and comparable to the main tobacco alkaloid nicotine due to its analogous addictive effect on the human brain. Chemically, both the alkaloids are tertiary amines and are responsible for the addictive nature of the substance. However, unlike, areca alkaloid arecoline, primary tobacco alkaloid nicotine is not considered a carcinogen.Prolonged use of AN/tobacco and its products including pan masala, gutkha, and scented supari are responsible for various diseases including oral potentially malignant disorders, oral submucous fibrosis, oral cancer, hypertension, diabetes and cardiovascular disease, etc. Contrary to tobacco control measures, stringent policies are either lacking or not implemented properly against the production, trade and use of AN around the world, especially in the Southeast Asian region, where its use is the most prevalent. Considering the potentially carcinogenic nature of AN alkaloids, well-framed policies to curb the use of AN in favor of public health are urgently warranted.