Skip to main content

A Scientific and Socioeconomic Review of Betel Nut Use in Taiwan with Bioethical Reflections


This article addresses the ethics of betel nut use in Taiwan. It first presents scientific facts about the betel quid and its consumption and the generally accepted negative health consequences associated with its use: oral and esophageal cancer, coronary artery disease, metabolic diseases, and adverse effects in pregnancy. It then analyzes the cultural background and economic factors contributing to its popularity in Asia. The governmental and institutional attempts to curb betel nut cultivation, distribution, and sales are also described. Finally, the article analyzes the bioethical implications of this often-ignored subject from the perspectives of human dignity, the good of health, vulnerable groups, cultural diversity, informed consent, and ethical blind spots.

This is a preview of subscription content, access via your institution.


  1. Research done on website on November 4, 2015.

  2. An abridged version of this paper has been previously published: J. Tham, G. Sem, E. Sit, M. Tai, “The ethics of betel nut consumption in Taiwan,” in Journal of Medical Ethics. Published Online First: 06 March 2017. doi: 10.1136/medethics-2016-103,990


Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Joseph Tham.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tham, J., Sem, G., Sit, E. et al. A Scientific and Socioeconomic Review of Betel Nut Use in Taiwan with Bioethical Reflections. ABR 9, 401–414 (2017).

Download citation

  • Published:

  • Issue Date:

  • DOI:


  • Betel nut
  • Bioethics
  • Medical ethics
  • Addiction
  • Oral cancer
  • Indigenous population
  • Vulnerable groups
  • Behavioral ethics