Across South Asia and many communities worldwide, supari — also known as betel nut or areca nut — is a culturally common chew enjoyed socially or after meals, but recent scientific evidence shows that its effects go far beyond a simple tradition. Studies and medical reviews now reveal a strong link between habitual supari chewing and serious health problems, including cardiovascular disease, metabolic disorders such as diabetes, and even various forms of cancer.
While occasional use might seem harmless to many, scientists have consistently found that regular and long-term consumption of supari contributes to health risks at both systemic and cellular levels. The nut contains psychoactive compounds like arecoline, which stimulate the nervous system and can increase heart rate and blood pressure, but more concerning are the metabolic and chronic disease pathways that emerge with habitual chewing. People who chew supari frequently have shown higher incidences of insulin resistance, elevated blood fats, central obesity, and components of metabolic syndrome — conditions that collectively increase the likelihood of developing type 2 diabetes and cardiac issues.
Beyond metabolic effects, betel nut chewing is classified by health authorities as a carcinogenic activity, meaning it significantly raises the risk of cancer. Repeated exposure to carcinogenic alkaloids in the nut has been linked to oral submucous fibrosis — a precancerous condition where the mouth’s connective tissue becomes stiff — as well as oral and throat cancers. These cancers often emerge after years of habitual chewing, especially when supari is combined with tobacco products such as gutka or paan, which compound the harmful effects and introduce additional carcinogens into the body.
The health impact isn’t restricted to metabolic syndrome or cancer alone. Cardiovascular disease is another well-documented risk associated with supari use. Observational research shows that regular chewing correlates with higher rates of hypertension, arterial hardening, and even coronary artery disease, especially in people who chew betel nut in large amounts over long periods. These effects stem from sustained changes in blood lipids and chronic inflammation, both of which burden the heart and vascular system.
Emerging clinical evidence also suggests that individuals who chew betel nut regularly may experience worse outcomes after acute cardiovascular events like heart attacks, with higher rates of re-hospitalization and overall cardiovascular mortality compared with non-chewers. This underscores how habitual use doesn’t just raise the risk of developing disease but may also lead to poorer prognoses once disease is established.
Another concern is the interplay between cultural perception and health reality. Supari is often viewed as a benign mouth freshener or social chew, leading many users — especially younger people — to underestimate its true health impact. The seductive marketing of processed forms like flavoured betel nut products promotes initiation and continued use, which can inadvertently make supari a gateway to tobacco habits or deeper nicotine dependence.
Public health experts argue that this perception gap has contributed to inadequate awareness about the real risks of supari chewing. Unlike smoking, which carries clear warnings and widespread prevention campaigns, supari remains socially accepted in many regions despite its documented harmful effects. This cultural acceptance means many people continue chewing without understanding the long-term consequences on heart health, metabolism, and cancer risk.
The science is clear: what may seem like a harmless or traditional habit carries significant systemic risks that affect nearly every major organ system, from metabolic regulation to cardiovascular health and cancer pathways. Reducing consumption, increasing awareness of its dangers, and supporting cessation efforts are critical steps in protecting long-term health — not just in South Asia, but wherever this practice persists.
