PORT MORESBY – American researchers have found that medications which help people quit smoking may also help betel nut addicts kick the habit.

Betel nut, or buai, is the fourth most used drug in the world after caffeine, alcohol and tobacco, with an estimated 600 million users.

The great gobs of blood red spittle that the practice generates can be seen on pavements, in the gutters and on walls in most towns in Papua New Guinea.

Cardiologist Isi Kevau, from the University of PNG, said he and his colleagues have observed the effects the stimulant has on the cardiovascular systems of avid chewers.

“We give the betel nut and we look at the heart rate and the heart rate will jump,” Kevau said.

“So if your heart rate is 60 beats per minute, the subjects within two minutes will have a heart rate of 78 and sometimes 90.”

Kevau said he has also seen narrowed arteries in some long-term chewers and suspects betel nut use heightens the risk of heart attack.

His research is limited in scope, but other health effects are well known.

The chewing of betel nut has been connected to several mouth diseases, in particular mouth cancer.

Until now, little was known about the effects of betel nut on the brain or how users become addicted.

Professor Roger Papke, from the department of pharmacology and therapeutics at the University of Florida, has discovered that an active ingredient in betel nut is arecoline, which works on the same receptors in the brain that are associated with nicotine addiction.

“So we know it’s these receptors that are associated with the craving that you get when you stop smoking,” Professor Papke said.

He said betel nut chewers show the same signs of addiction as smokers, particularly the need to keep using a drug to avoid withdrawal.

The discovery raises the possibility that drugs that have been developed to help people quit smoking, such as Champix, may also be useful to betel nut chewers.

“This is how we normally treat addictive behaviours, we give them a drug that when you take the one you are addicted to fills in the gap. So that’s methadone for heroin users, and it can Champix for smokers,” Professor Papke said.

Professor Papke said the next step to test his theory would be to conduct a clinical trial of the drugs on betel nut chewers.

“I’m trying to find collaborators in places where the usage is common enough and where the infrastructure for research is sufficient to get a patient population and fund a study,” he said.

Professor Papke said pharmaceutical giant Pfizer has indicated its willingness to supply the drugs if a clinical trial can be organised.

In Papua New Guinea, there are currently no services of any kind for people who want to quit chewing betel nut.

Kevau said more research on the health impacts was needed.

He said even if drugs that help people quit smoking were found to be useful, he was not sure if many people would use them, given how culturally ingrained the use of betel nut was.

“Every time I go fishing with my brothers who chew betel nut, and in the middle of the night some of them have stopped talking, they chewed their betel nut and then all of a sudden they’re very chirpy, within a couple of minutes they are talking again,” he said

“I say ‘what’s wrong with you guys?’ ‘We’re just awake from the betel nut’.”

There are calls to ban the practice of betel nut chewing in Papua New Guinea.

Kevau said a ban on the consumption of betel nut in public places in Port Moresby has had mixed success.

“I’ve seen people being chased by the security guards and the police,” Kevau said.

“But those people who are supposed to take the betel away, they end up chewing the betel nut themselves, so it’s a very complex story here.”

- ABC