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Arch Otolaryngol Head Neck Surg. 2003;129:699-700.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

THE LITTLE India neighborhood in Singapore is visually dazzling. Shops are bedecked with flower garlands of yellow marigolds, purple orchids, and all the daily accoutrements of Indian culture. We stopped short at artfully arranged stacks of large round flat leaves. We were excited to discover that they were indeed betel leaves. You don't see betel leaves on the streets of New York! Nearby, hung strips of foil packets, their sinister nature more manifest. These were guthka packets, bearing the obligatory warning: "Smoking Kills."

Figure appears in full text version. Additives such as sugar and perfumes, and slick packaging and marketing, have exploded guthka consumption among young people.

Guthka is a commercially manufactured "pan masala" mix, marketed as a mouth freshener, stimulant, oral cleanser, and digestive aid. It is a lethal blend of powdered chewing tobacco, areca nut (betel nut), lime, as well as preservatives, perfumes, and flavorings such as menthol. By analogy, this processed and refined . . . [Full Text of this Article]