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Areca nut alone has been evaluated as carcinogenic to humans (Group 1) by the International Agency for Research on Cancer (IARC),[2] yet it remains one of the most used addictive substances globally, after nicotine, alcohol, and caffeine.[3] ,[4] When areca nut is placed in the buccal cavity, the alkaloid arecoline, which has been evaluated as probably carcinogenic to humans (Group 2A) by IARC,[5] is absorbed producing a psychoactive effect that is believed to drive addiction

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