Death highlights dangers of chewing betel nuts

The death of a Chinese singer who shared his excruciating battle with oral cancer caused by his habit of chewing betel nuts has rekindled discussions about tightening controls on sales of the addictive snack that has long been in the shadow of its links to cancer.

Fu Song, a 36-year-old singer from Hunan province, was reported to have died on Sept 10 from recurrent oral cancer. In the last video he posted on the short-video platform Douyin — the Chinese version of TikTok — Fu, frail and in pain, showed a gaping wound on the side of his cheek to highlight the dangers of the illness.

"I want to use my painful experiences to tell the public that chewing betel nuts can bring horrendous results," he said. "Please stay away from betel nuts and value your life."

By Sept 21, the hashtag "36-year-old singer who chewed betel nuts for six years passed away due to oral cancer" had been viewed more than 250 million times on Sina Weibo, the Chinese Twitter-like platform.

Betel nuts contain arecoline, a cancer-causing chemical, and were classified as a Group 1 carcinogen by the World Health Organization in 2003. Regular chewing of the nut also causes chronic irritation and inflammation of the oral mucosa, increasing the risk of developing precancerous conditions.

However, due to its addictive stimulant similar to nicotine, betel nuts have for decades enjoyed widespread popularity in some regions in China, including Hunan, Hainan and Guangdong provinces.

Xu Fan, a 29-year-old from Hunan province, said she grew up seeing fellow high school classmates trying betel nuts out of curiosity. "Years later after we met, I found their cheekbones had grown much larger due to regular consumption," she said.

Xu said that despite frequently hearing about the harmful effects of the snack, its consumption appears unabated in her hometown. "Betel nuts are not as popular as cigarettes, but they are very easily bought from streetside stores," she added.

In recent years, authorities have attempted to put restraints on the industry, including an advertising ban issued by the National Radio and Television Administration in September last year that forbids all related advertisements on radio, television or online.

Betel nuts were also removed from the updated version of the food production permit catalog released by the State Administration of Market Regulation in 2020.

Amid heated discussions following the singer's death, local market regulators in Zhejiang, Sichuan and Jiangxi provinces rolled out notices to ban all sales of betel nuts as a food product.

The Hainan Betel Nut Association said in a statement released on Sept 21 that industry insiders have been pushing for developing new technologies to reduce the amount of carcinogens contained in the nuts and lower the harm caused to people's mouths. It also suggested exploring the nut's therapeutic properties.

Hainan province in South China is home to over 95 percent of the country's betel nut planting area, and millions of farmers rely on the industry as their main source of income, it said.

The association also suggested authorities step up the formulation of rules and standards for the industry, and enhance the research and development of different betel nut-based products.

Xu Baohua, head of the China-Japan Friendship Hospital's dental center in Beijing, said that the betel nut's link to cancer should be highlighted in education campaigns.

He suggested adding compulsory warning labels on betel nut packaging, clarifying the harm of the snack to the public and enhancing supervision over the business.