Betel quid with tobacco, popularly known as gutka or gutkha is mainly consumed in the Indian subcontinent – India, Bangladesh and Pakistan. It is a dry commercial preparation using tobacco, betel leaf, areca nut (inaccurately known as betel nut), slaked lime (calcium hydroxide) and catechu. Spices such as saffron, cardamom, cloves, mustard, turmeric, anise seeds or sweeteners are also added for flavor. Gutka is marketed in sachets and tins.
After the introduction of tobacco in the 17th century, chewing of tobacco along with betel quid gradually became socially acceptable. In the later years, betel quids are chewed in various forms – khaini, mawa, mainpuri tobacco, and more recently, pan masala. The main reason behind the popularity of these variants is that fresh betel leaves are highly perishable.
Although all betel quid ingredients can be consumed without including tobacco, most habitual chewers prefer having tobacco in their quids. This is because tobacco is the only ingredient which causes addiction.
Studies reveal prevalence of different kind of chewing habit throughout India. For instance, in the Ernakulum district chewing of betel quid is very popular. Whereas, in the northern part of India, tobacco and lime known as â€˜khaini’ is the most popular form of betel quid.
To prepare khaini , small amount of tobacco is placed in the palm along with a dash of lime; it is thoroughly mixed and rubbed using the thumb and is made ready to place inside the mouth.
There is also variance regarding the exact placement of tobacco and lime in the mouth. In Pune (India), the quid is placed in the canine region; whereas, people in Darabhanga (India) enjoy placing their quids inside their labial groove.
Betel quid with tobacco is found to be associated with a number of ill effects on health. Some of these are nicotine addiction, precancerous lesions of the oral cavity (leukoplakia and erythroplakia), squamous cells carcinomas of the mouth, tongue, lip and pharynx.