From Betel Nut Addiction to Belonging

After seeing firsthand the devastating consequences of betel nut use, nurse practitioner Elena Taneva is on a mission to help people break free from the habit.

During the Solomon Islands for Christ campaign in July, she worked with the Amazing Facts Oceania team, which ran mobile health clinics in partnership with 10,000 Toes ambassadors, offering a range of services, including oral examinations, medical and nursing care, addiction education, optometry, and pastoral support to more than 1,000 people. 

Betel nut use is widespread in the Solomon Islands, where, though it is technically illegal, is commonly sold on the street. An estimated 80 percent of the population uses it. Recognizing the scale of the issue, the health outreach also included dedicated betel nut workshops led by Taneva.

“The experience convinced me that simply telling people, ‘Betel nut is bad for you,’ is not enough,” she says.

“Addiction affects the whole person—the body, mind, family, finances, relationships, and spiritual life. People need knowledge, practical alternatives, compassionate support, hope, and real connection, which makes addiction obsolete.”

Taneva’s enthusiasm for tackling the issue has earned her the nickname the “Betel Nut Queen.”

“I accept the name with a smile, but I hope the real message behind it is that these individuals matter,” she says. “Every mouth we examine belongs to a person whom God loves.”

Her passion for the issue has also been shaped by her clinical work in Guam, where she diagnoses and follows patients with oral cancer linked to betel nut use, as well as patients experiencing heart failure linked to methamphetamine.

The International Agency for Research on Cancer classifies areca (betel) nut as carcinogenic to humans. Its use is associated with oral cancer and oral submucous fibrosis, a potentially malignant condition that can progressively restrict a person’s ability to open their mouth.

“I have lost so many young patients in their 20s and 30s as a result of betel nut,” she says. 

Those experiences have prompted her to look beyond the physical consequences of addiction and consider what drives people to use addictive substances in the first place. 

“Rather than simply condemning the habit, I became fascinated by the questions: Why do people chew? What does betel nut provide socially, culturally, and psychologically? And if we ask someone to give it up, what are we going to offer in its place?”

That approach is particularly important in South Pacific communities, where substances such as betel nut may have longstanding cultural and social associations.

Beyond Betel Nut

But Taneva’s concerns extend beyond betel nut. She also highlights tobacco and nicotine, alcohol, marijuana, and methamphetamine, with the prevalence and impact of each differing between Pacific countries and communities.

Methamphetamine, in particular, is an issue the South Pacific needs to take seriously, she says. A 2024 report from the United Nations Office on Drugs and Crime (UNODC) identified Fiji, Papua New Guinea, and Tonga among the Pacific countries particularly affected by methamphetamine trafficking.

“Methamphetamine worries me because it can rapidly affect almost every dimension of life,” she says. “We should not wait until the problem becomes overwhelming.”

She believes churches and health professionals need to understand addiction as more than an individual health behavior.

“Addiction is biological, psychological, social, and spiritual. Therefore, our response must also address the whole person.”

The original version of this story was posted on Adventist Record.