This note reports the results of a 1995 survey of betel nut chewing pr
actices among indigenous residents of the Republic of Palau. Of those
surveyed in a nonprobability sample of 1,110 individuals, 76 percent r
egularly chewed betel nut, and of these, 83 percent regularly added a
tobacco product to the chew. Betel nut users did not differ significan
tly from nonusers with respect to religion and years lived outside of
Palau; however, a significantly higher proportion of females used both
betel nut and betel nut-associated tobacco products. The rate (freque
ncy) of chewing significantly increased with age and education levels
and was significantly higher among males, those who included tobacco p
roducts, and those who indicated a religious affiliation other than Ro
man Catholic, Lutheran Protestant, Seventh Day Adventist, or Modekngei
. The estimated annual market value of betel nut and associated ingred
ients consumed in Palau exceeds $9.2 million.