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Guidelines on areca nut prevention should be included in national cancer control pro- grammes where appropriate, including banning spitting in public places, prohibiting sales to minors, and putting cancer warning labels on areca nut product packaging.18 Finally, although men are the main consumers of smokeless tobacco or areca nut in most regions of the world, the prevalence of smokeless tobacco or areca nut consumption among women in southern African and southeast Asian countries is higher than among men (eg, 7% of women vs 2% of men in Botswana19 and 5% of women vs 1% of men in Thailand20)

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