Gutka is a type of betel quid and chewing tobacco preparation made of crushed areca nut (also called betel nut), tobacco, catechu, paraffin wax, slaked lime (calcium hydroxide) and sweet or savory flavourings, in India, Pakistan, other Asian countries, and North America. Using gutka is highly addictive and can cause various harmful effects such as head and neck cancer, oral and oropharyngeal cancers, coronary heart disease, as well as negative reproductive effects including stillbirth, premature birth and low birth weight. Gutka is manufactured in the sub-continent and exported to a few other countries, often marketed under the guise of a "safer" product than cigarettes and tobacco. Reported to have both stimulant and relaxation effects, it is sold throughout South Asia and some Pacific regions in small, individual-sized foil packets/sachets and tins that cost between 2 and 10 rupees each. It is widely consumed in Northern India, Pakistan and the Madhesh region of Nepal. Gutka is consumed by placing a pinch of it between the gum and cheek and gently sucking and chewing, similar to chewing tobacco. Due to containing cancer-causing substances, it is subjected in India to the same restrictions and warnings as cigarettes. Highly addictive and a known carcinogen, gutkha is the subject of much controversy in India. Many states have sought to curb its immense popularity by taxing sales of gutkha heavily or by banning it.
Characteristics Gutka is a commercially produced form of smokeless tobacco. Manufacturers add sweet or savory flavours, making it more appealing to women and young people in some locations. The combinations of gutka ingredients vary according to local preferences. Spices may include mustard, turmeric, anise seeds, cardamom, saffron and cloves. In addition to areca nut, nicotine, slaked lime, paraffin and catechu, it can be laced with thousands of chemicals. It is a powdery, granular, light brownish to white substance. Within moments of chewing mixing with saliva, the gutkha begins to dissolve and turn deep red in colour. It may impart upon its user a "buzz" somewhat more intense than that of tobacco chewing, snuffing and smoking. Gutka turns saliva bright red, and when it is chewed long and often enough it will stain a user's teeth bright red too. Saliva is generally spat onto a wall or at the ground, causing a red stain that is quite resistant to the elements. Some building owners have taken to combating this by painting murals of gods on their walls, with the idea that gutkha chewers would not spit on a god. "Quid chewing has claimed to produce a sense of well being, euphoria, warm sensations of the body, sweating, salivation, palpitation and heightened alertness, tolerance to hunger, and increased capacity and stamina to work."
Health effects Gutka is highly addictive, represents a major health risk, has no safe level use and is not a safe substitute for smoking. Globally smokeless tobacco products such as gutka contribute to 650,000 deaths each year with a significant proportion of them in Southeast Asia. Using gutka can cause a number of adverse health effects such as head and neck cancer, oral cancer, oral submucous fibrosis, oesophagus cancer, and pancreatic cancer, cardiovascular disease and asthma. It also raises the risk of fatal coronary artery disease, fatal stroke and non-fatal ischaemic heart disease When a person chews gutka, the mixture directly enters the system through the oral cavity, which absorbs 28 cancer-causing chemicals. Gutka can cause adverse reproductive effects including stillbirth, premature birth and low birth weight. Nicotine in gutka that are used during pregnancy can affect how a baby's brain develops before birth. Gutka use causes the production of various reactive free radicals that induce oxidative stress, particularly in oral tissues. Gutka exposure can lead to the oxidation of guanine bases in DNA to form 8-hydroxy-2'-deoxyguanosine (8-OHdG or its tautomer 8-oxo-dG) as a major byproduct. Exposure to Gutka tends to be highest in saliva and urine as evaluated by measuring 8-OHdG in DNA. Creative advertising by tobacco companies and lack of accessible information for the public leads to many gutka users being unaware of the dangers it can bring. Often users believe that gutka can act as a digestion aid, kill germs and generally give a sense of well-being. In fact 34.4% of smokers have switched to smokeless tobacco use as way to quit but there is no scientific evidence that using gutka can help a person quit smoking. As of 2015 it was the fourth most common addictive product worldwide.
Usage
Use of gutka and other forms of tobacco are culturally ingrained and use can begin at a young age. Smokeless tobacco use is most common in India where oral cancer accounts for 30 to 40% of cancer cases. Its use has been reported in Thailand, Sri Lanka, Bangladesh, Pakistan, Malaysia, Cambodia, China, Indonesia and New Guinea. Immigrants to the United Kingdom, parts of Africa, Australia, North America have brought their habits with them. Gutka is readily available in these locations, especially in highly populated areas. Immigrants to the United States where spitting in public is not as socially acceptable, learn to be discreet. Those in the lower socioeconomic populations are especially at risk. It is here that access to education and treatment is limited. Easy access and extremely low cost lead to early addiction and the prevalence of gutka use. Precancerous lesions have been observed in young children and symptoms of cancer often appear by high school or college age. Smoking is not allowed in many places, and when done by children, is disapproved of. In contrast gutka use, being all but invisible to others, is the method of choice. A New York Times article reported in 2002 that sales of gutka and the tobaccoless version, paan masala, reached $1 billion a year.
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