Health officials take on betel-nut business

LEGAL HIGH: Although betel nuts are Taiwan's No. 2 crop after rice, the government feels that the health hazard it presents outweighs any economic benefits

BLOOMBERG

Mon, Jan 30, 2006 - Page 5

The Taiwanese government's plan to curb cancer faces tough opposition: about 60,000 women who sit in roadside glass booths, often wearing little more than a bikini, selling the nation's oldest legal drug.

The so-called betel-nut beauties, who are unique to Taiwan, peddle the nation's second-largest crop to 17.5 percent of the adult male population, according to government estimates.

Chewing addictive betel nuts, the seed of the betel palm, increases the risk of mouth cancer, according to the Department of Health. Officials are encouraging farmers to plant alternatives to the US$359 million annual crop, urging about 1.6 million users to quit.

"We aren't very optimistic," said Wu Chien-yuan (吳建遠), a Health Department section chief in Taipei. "We'll focus on preventing people from starting."

Betel, or areca, nuts increase the heart rate and induce a mild sense of excitement, said Hahn Liang-jiunn (韓良俊), an oral and facial surgeon at Taipei's National Taiwan University Hospital.

As many as 400 million people from East Africa to Indonesia chew the seeds and leaves regularly, the British Medical Journal reported in April 2002.

Taiwan's beauties are even featured in tourist guides. Their betel-nut stands are a favorite among long-distance drivers.

"I use betel nuts to mark time and to keep myself alert," said Shen Ting-hui, 28, a truck driver from Taoyuan County, who has been chewing betel nuts for 10 years.

Paying a saleswoman dressed in a blue shirt, white shorts and white boots, Shen said the beauties' visual sales pitch encouraged him to buy from them.

"Of course I want to go to someone good-looking," he said.

While the government's goals are modest -- cutting the number of users by half a percentage point during the next four years -- the beauties are not.

`Government is stupid'

"Our government is stupid," said saleswoman Yu Hui-min, 38, dismissing the notion that betel nuts cause cancer. She wore a brown shirt and miniskirt and red high heels in her neon-lit booth in central Taipei.

"In my home town, betel nuts are a treat for guests," she said.

Betel-nut beauties emerged in the early 1990s as Taiwanese companies sought to cut labor costs by moving factories to China. Many of the beauties are unskilled workers who can't find better jobs because of that shift, said Robin Jai (翟本瑞), dean of social sciences at Nanhua University in Chiayi County.

Taiwan has more than 100,000 betel-nut booths, Jai said. Artist Christian Wu (吳瓊華), who said she interviewed more than 200 saleswomen during a 10-year study, estimates that 60,000 of the booths are run by betel-nut beauties.

"With not much money, I can own my own business and wear beautiful clothes to work," said Lin Hsiao-wei, 35, who wore a leopard-print miniskirt as she dispensed betel nuts in the central town of Toufen (頭份), Miaoli County.

"This is a good job," she said.

Lin, a former garment-factory worker, said she sells NT$8,000 to NT$9,000 of betel nuts a day. Her booth cost about NT$150,000 to set up and her profit margin ranges from 33 percent to 50 percent, she said.

Mouth cancer

People who chew betel nuts, drink alcohol and smoke cigarettes are 123 times more likely to get mouth cancer than those who don't, according to the Department of Health.

Mouth cancer killed about 15 of every 100,000 Taiwanese men in 2003, making it the fourth most lethal form of the disease, department figures show.

"There is sufficient scientific evidence that betel nuts can cause oral cancer," Hahn said. They also have been linked to asthma, diabetes and cancers of the esophagus and anus, he said.

A 2000 study of ethnic Indian users in London found that paan masala, a combination of spices and betel nut wrapped in a betel leaf, can be as addictive as cocaine, according to the British Medical Journal.

"Patients describe typical dependency symptoms, with difficulty in abstaining, withdrawal symptoms including headache and sweating, and need for a morning paan to relieve these symptoms," the 2002 Journal report said.

To combat the habit, the government is running anti-betel advertisements and education campaigns, including betel-nut prevention days.

Officials are also helping farmers to substitute orange and tangerine trees and Chinese herbs for betel crops.

Nut production declined 17 percent to 143,368 tonnes in 2004 from a peak of 172,574 tonnes six years earlier, according to the Council of Agriculture.

Still, the crop remains the country's second-largest, after rice, and affects the livelihood of 70,000 farming families, the council estimates.

Betel-nut sellers are coming under pressure, too. The police are stepping up inspections of betel-nut beauties for moral and safety reasons, said Patricia Huang, a spokeswoman at the Ministry of the Interior.

"Their revealing clothing may distract drivers and cause car accidents, as well as prompt male clients to harass or even sexually assault them," Huang said.

County officials are helping, closing down booths if they judge sellers' clothing to be too revealing, said Wang Yun-tsen, deputy director of economic development in Taoyuan County.

Taoyuan "is the main gate of our nation," Wang said.

The saleswomen "aren't a good subculture and we don't want people to use them to attract tourists."

Teng Chun-han, 28, a truck driver from Taoyuan, said the government should stop harassing the women, who are only trying to make ends meet.

He spends 12 hours a day on the road and uses betel nuts to stay alert, he said, paying a saleswoman wearing a short black dress and black boots.

"Eight out of 10 users will buy from betel-nut beauties," Teng said.