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National Cancer Institute

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Arecoline, a component of areca nut, has been shown to induce several pro-carcinogenic changes, including the production of nitrosamines and reactive oxygen species (Moutasim et al., 2011), and increased expression of inflammatory cytokines, including tumor necrosis factor-, interleukin-6, interleukin-8, and interleukin-1- (Shiu and Chen, 2004) to induce changes in oral microbiome communities contributing to oral carcinogenesis (Lee et al., 2017

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Risks of Smokeless Tobacco or Chewing Tobacco However, the consequences of tobacco, especially of its smokeless type, can be horrifying

PMID: 25170798 pubmed.ncbi.nlm.nih.gov/25170798/