Smokeless tobacco (ST) is any tobacco product that is placed in the mouth or nose and not burned. The types of ST products used in the UK often contain a mix of ingredients including areca (betel) nut, slaked lime, spices, flavourings and sweeteners. The areca nut is the fruit of the areca catechu tree and contains arecedaine, a hydrolyzed derivative of the alkaloid arecoline. This stimulates the central nervous system, giving a sensation of alertness, wellbeing and dizziness (Javed et al, 2010). Areca is included in a number of smokeless products, such as gutkha (or zarda), pan masala (or betel quid or paan), naswar and dry snuff (see Table 1 and Figure 1).
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