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Chewing betel nuts, even without the commonly used flavorings, has adverse health effects, the Health Promotion Administration (HPA) said on Thursday last week. Many people erroneously believe that chewing “all-natural” betel nuts is harmless to their health, HPA Cancer Prevention and Control Division Director Lin Li-ju (林莉茹) said. Arecoline, a nicotinic stimulant that the WHO’s International Agency for Research on Cancer classifies as a Group 1 carcinogen, occurs naturally in betel nuts and cannot be removed before consumption, she said. Chewing betel nuts also causes abrasions in the mouth, which can trigger the growth of premalignant tissue that precedes cancer, she said. An elevated ....