For years Huang Sheng-yi helped feed the nation’s addiction to betel nut, planting thousands of the trees on his mountainous farm. Today, he has felled most of them, incentivized by the government to grow something else, as part of its push to reduce the availability of the nut, which is a stimulant and also a known carcinogen linked to oral cancer.
However, the green nut, which is often wrapped in a betel leaf spread with slaked lime to enhance the stimulative effect, is still ubiquitously available at roadside kiosks across the nation and chewed by millions daily.
The chance of a betel nut user developing oral cancer is 28 times that of the average person, according to the Ministry of Health and Welfare.
Photo: Sam Yeh, AFP
“Simply promoting the health risks is not enough. Betel nut chewing is too deeply ingrained in society,” said Chuang Li-chen (莊麗真), project manager at the Sunshine Social Welfare Foundation, an non-governmental organization that offers rehabilitation services for oral cancer survivors.
Since a 2003 study confirmed betel nut as a carcinogen there has been a gradual decline in popularity, although about 2 million people still chew the nut, according to government figures.
The nut, which stains users’ teeth blood red, remains popular among the working class, particularly men, who rely on its stimulant properties to better cope with long hours of manual labor.
The government is attempting to reduce the amount of betel nut available as part of its plan to tackle the issue.
It subsidizes farmers as much as NT$250,000 per hectare if they convert to other crops.
Huang now grows oil-seed camellia, which produces an edible extract often likened to olive oil, at his farm in Nantou County’s Lugu Township (鹿谷).
However, the 57-year-old said many are still hesitant to make the leap.
It will be more than two years before he can harvest the oil-seed camellia, he said, and he is only able to stay afloat because he has another tea-growing business.
“Farmers are reluctant because managing a new crop is much harder,” Huang said. “There needs to be even greater guidance and incentives to really make a difference.”
Authorities concede the program has not yet made a significant dent since it started in 2014.
Of the 42,940 hectares of betel nut plantations in the nation, only 435 have changed crops under the initiative, although more might have done so without government assistance, but Agriculture and Food Agency Deputy Director-General Su Mao-shiang (蘇茂祥) said applications have risen this year off the back of government offers of more support.
“We hope more farmers can participate in the conversion,” Su said.
Betel nut has been part of Aboriginal culture for thousands of years, used in ceremonies and rituals.
At the height of its popularity it was known as “green gold,” because it was such a lucrative crop — second only to rice in value — and many had come to rely on it for their livelihood.
Its skinny palms still pervade parts of the rural landscape and flashing signs at roadside kiosks flag down drivers, although they are lower key than in the past.
Young women in skimpy outfits — known as “betel nut beauties” — often used to staff the stands, but they are less common now after a government crackdown.
Despite the various measures to curb production and use, campaigners said there is still too little awareness of the damage betel nut can cause.
Former addict Chen Yung-an wishes he had believed his doctor when told he had early signs of oral cancer two decades ago.
“I didn’t think it was possible. Other people chewed it for years and nothing happened to them,” said Chen, now 53, who had a tumor removed three years ago, taking a chunk out of his right jaw.
Chen went through 200 betel nuts a day at the peak of his habit, saying it served as a social lubricant among coworkers.
“In the rural areas betel nut is like fruit. We didn’t have the concept that it was bad for us,” Chen said. “It felt uncomfortable whenever my mouth wasn’t moving. While driving back I would buy NT$200 to eat in the car. My mouth would only rest when I was sleeping.”
Today, he is limited to eating soft and bite-sized foods to avoid choking, and has not worked since the disfiguring surgery.
“Of course, it’s hard to find a job now. I would have to face the looks people give me,” he said.
The disease can take 10 to 20 years to develop, which means many people do not seek treatment until it is too late, Chuang said.
Only about half of the population is aware that betel nut directly induces cancer, even without any other additives, she said.
“We’ve let the betel nut industry develop for decades. We can’t just ignore the livelihoods of these growers and vendors,” Chuang said.
It needs more coordination between the education, agriculture and economic departments, she said.
“We need a comprehensive approach to effectively tackle this problem at its roots,” Chuang added.
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