Letter to the Editor

Merchant and his colleagues use tertiles of paan-years in their analysis of the increased odds ratios for risk of oral cancer in those using betel nut (Areca catechu) with, or without, the addition of tobacco to the leaf-wrapped quids.1 Because these findings are of considerable inportance for health education of the 10% of the worlds population who use paan, it would be helpful if the authors could reassure readers that this finding is not directly attibutable to increases in risk with age: a point not covered in the text. In a study of risk factors for hyperglycaemia in Bangladeshi Asians we have reported increases in waist size, a major marker for subsequent diabetes, with increasing betel-usage. We could not, however,…