| Summary: | Background and challenges to implementation
BQ/AN use is prevalent among approximately 600 million
people globally and, is a risk factor for oral and esophageal cancers. It has
also shown effects on the cardiovascular, nervous, GI and metabolic,
respiratory, and reproductive systems. Research is needed to understand and
implement effective prevention and control of BQ/AN, screening and treatment
for related cancers, policy, and economic impacts.
Intervention or response
In 2016, the US National Cancer Institute and US National Institute of
Dental and Craniofacial Research in collaboration with academic and government
institutions based in U.S, Malaysia, Taiwan convened a group of experts to gain
a greater understanding of the impact of BQ/AN use, both with and without
tobacco. Consequently, a literature review is being conducted to further inform
global research initiatives around BQ/AN policies and implementation strategies.
Results and lessons learnt
The specific recommendations from the meeting are: 1) Expand global
epidemiology of BQ/AN use (incl. understanding of the cultural and social
norms) 2) Establish prevention and cessation programs for BQ/AN users 3) Create
evidence-based screening and early diagnosis oral cancer programs 4) Carry out
policy interventions around Trade, Bans including use, manufacture, sales and
agriculture, Health service provision, Crop substitution, and Public Awareness
Outreach. There are also lessons learned from tobacco control evidence that can
inform interventions in prevention and policy to address the burden. The review will build on these findings by
systemically emphasizing both research strengths and gaps to provide
recommendations for future research and policy agendas.
Conclusions and key recommendations
The evidence shows that BQ/AN are widely used globally. There are major
differences between tobacco and BQ/AN use which impede governments and
communities from taking actions. To reduce the use of BQ/AN and associated adverse
health effects, it is imperative to address the research gaps, with a focus on
the translation of that evidence to effective policy and programs.
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