Paan is chewed as a palate cleanser and a breath freshener. It is offered to guests and visitors as a sign of hospitality and at the beginning of social events. It has a symbolic value at ceremonies and cultural events in south and southeast Asia. Paan makers may use mukhwas or tobacco in paan fillings. Most paan contains areca nuts as a filling. Other types include what is called sweet paan, where sugar, candied fruit and fennel seeds are used.
Areca nut is often mistakenly translated in the English language as "Betel nut", a misnomer, for the betel vine has no nuts. This name originated with the fact that the betel leaf is chewed along with the areca nut, the seed of the tropical palm Areca catechu. Supari or adakka is the term for the nut in many Indic languages.
Although "paan" is generally used to refer to the leaves of the betel vine, the common use of this word refers mostly to the chewing mixture wrapped in the Betel leaves.
Paan has various forms and flavours. The most commonly found include:
There are a variety of betel leaves grown in different parts of India and Bangladesh; the method of preparation also differs from region to region. The delicately flavoured paan from Bengal is known as Deshi Mahoba. Maghai and Jagannath are the main paans of Benaras. Paan prepared from small and fragile leaves from south India is known as Chigrlayele. The thicker black paan leaves, the ambadi and Kariyele, are more popular and are chewed with tobacco.
The International Agency for Research on Cancer (IARC) regards the chewing of betel-quid and areca nut to be a known human carcinogen. The main carcinogenic factor is believed to be areca nut. A recent study found that areca-nut paan with and without tobacco increased oral cancer risk by 8.4 and 9.9 times respectively.
Chewing the mixture of areca nut and betel leaf is a tradition, custom or ritual which dates back thousands of years from South Asia to the Pacific. Ibn Battuta describes this practice as follows: "The betel is a tree which is cultivated in the same manner as the grape-vine; … The betel has no fruit and is grown only for the sake of its leaves … The manner of its use is that before eating it one takes areca nut; this is like a nutmeg but is broken up until it is reduced to small pellets, and one places these in his mouth and chews them. Then he takes the leaves of betel, puts a little chalk on them, and masticates them along with the betel."
It constitutes an important and popular cultural activity in many Asian and Oceanic countries, including Myanmar, Cambodia, the Solomon Islands, Thailand, Philippines, Laos, and Vietnam. It is not known how and when the areca nut and the betel leaf were married together as one drug. Archaeological evidence from Thailand, Indonesia and the Philippines suggests that they have been used in tandem for four thousand years or more.
Paan is a ubiquitous sight in many parts of South and Southeast Asia, It is known as beeda (in Tamil), Killi/Tambulam in (Telugu), and 'sireh (in Bahasa Melayu). In urban areas, chewing paan is generally considered a nuisance because some chewers spit the paan out in public areas. The red stain generated by the combination of ingredients when chewed are known to make a colorful stain on the ground. This is becoming an unwanted eyesore in Indian cities like Mumbai, although most see it as an integral part to Indian culture. This is also common in some of the Persian Gulf countries like the UAE and Qatar, where many Asians live. Recently, the Dubai government has banned the import and sale of Paan and the like.
According to traditional Ayurvedic medicine, chewing areca nut and betel leaf is a good remedy against bad breath (halitosis). However, as mentioned previously in this article, chewing this mixture can possibly lead to oral cancer.
In Bangladesh paan is chewed all over the country by all classes of people. Paan is offered to the guests and festivals irrespective of all religion. A mixture called Dhakai pan khili is famous in Bangladesh and the subcontinent. The sweet pan of the Khasi tribe is famous for its special quality. Paan is also used in Hindu puja and wedding festival and to visit relatives. It has become a rituals and tradition and culture of Bangladesh society. Adult women gathered with pandani  along with friends and relatives in leisure time.
In the Indian Subcontinent the chewing of betel and areca nut dates back ( circa 2600 BC ) to the pre-Vedic Harappan empire. Formerly in India and Sri Lanka it was a custom of the royalty to chew Areca nut and betel leaf. Kings had special attendants carrying a box with the ingredients for a good chewing session. There was also a custom to chew Areca nut and betel leaf among lovers because of its breath-freshening and relaxant properties. Hence there was a sexual symbolism attached to the chewing of the nut and the leaf. The areca nut represented the male and the betel leaf the female principle. Considered an auspicious ingredient in Hinduism, the Areca nut is still used along with betel leaf in religious ceremonies and also while honoring individuals in most of Southern Asia.
The skilled paan maker is known in North India as a paanwala. In some parts of northern India, paanwalas are also known as panwaris (or panwadis). Many people believe that their paanwala is the best, considering it an art that takes practice and expert touch.
Paan eating was taken to its zenith of cultural refinement in the pre-partition era in North India, mainly Lucknow, where paan eating became an elaborate cultural custom, and was seen as a ritual of the utmost sophistication. The traditional way of paan making, storing and serving is interesting. The leaves are stored wrapped in a moist, red colored cloth called 'shaal-baaf', inside a metal casket called 'PaanDaani'. The PaanDaani has several lidded compartments, each for storing a different filling or spice. To serve, a leaf is removed from the wrapping cloth, de-veined, and kattha and lime paste is generously applied on its surface. This is topped with tiny pieces of Areca nuts, cardamom saffron, (un)/roasted coconut pieces/powder, cloves, tobacco etc, according to the eater's personal preferences. The leaf is then folded in a special manner into a triangle, called 'Gilouree' and is ready to be eaten. On special occasions, the gilouree is wrapped in delicate silver leaf (vark). To serve, a silver pin is inserted to prevent the gilouree from unfolding, and placed inside a domed casket called 'Khaas-daan'. Alternatively, the gilouree is sometimes held together by a paper or foil folded into a funnel with the gilouree's pointed end inserted inside it. Voracious paan eaters do not swallow; instead, they chew it, enjoying its flavours, and then spit it into a spittoon.
It is interesting to note that paan made it into Bollywood in the 1970s. In the 1978 Bollywood movie Don starring Amitabh Bachchan there is a song about paan. The remake Don - The Chase Begins Again starring Shahrukh Khan also contains a song and dance number about paan. Alternately, Varanasi erstwhile Benares and many other North Indian cities are famous for paan eating.
Paan has been part of the culture in the Philippines. Known mainly as tepak sirih in Bahasa Melayu, it is also commonly and simply referred to as nga-nga in the Tagalog dialect. Nga-nga literally means "to chew/gnaw". Nowadays, it is mostly popular with the older populations.
Kun-ya is the word for paan in Myanmar, formerly Burma, and has a very long tradition. Both men and women loved it and every household, right up to the 1960s, used to have a special lacquerware box for paan called kun-it which would be offered to any visitor together with cheroots to smoke and green tea to drink. The leaves are kept inside the bottom of the box which looks rather like a small hat box but with a top tray for small tins, silver in well-to-do homes, of various other ingredients such as the betel nuts, slaked lime, cutch, aniseed and a nut cutter. The sweet form (acho) is popular with the young but grownups tend to prefer it with cardamom, cloves and tobacco. Spittoons therefore are still ubiquitous, and signs saying "No paan-spitting" are commonplace as it makes a messy red splodge on floors and walls; many people display betel-stained teeth from the habit. Paan stalls and kiosks used to be run mainly by people of Indian origin in towns and cities. Smokers who want to kick the habit would also use betel nut to wean themselves off tobacco.
Taungoo in Lower Burma is where the best areca palms are grown indicated by the popular expression "like a betel lover taken to Taungoo". Other parts of the country contribute to the best paan according to another saying "Tada-U for the leaves, Ngamyagyi for the tobacco, Taungoo for the nuts, Sagaing for the slaked lime, Pyay for the cutch". Kun, hsay, lahpet (paan, tobacco and pickled tea) are deemed essential items to offer monks and elders particularly in the old days. Young maidens traditionally carry ornamental betel boxes on a stand called kundaung and gilded flowers (pandaung) in a shinbyu (novitiation) procession. Burmese history also mentions an ancient custom of a condemned enemy asking for 'a paan and a drink of water' before being executed.
The consumption of paan has been a very popular cultural tradition throughout Pakistan since the start, especially in Memon and Muhajir households. Pakistan grows a large variety of betel leaf (specifically in the coastal areas of Sindh) although paan is imported in large numbers from countries like Bangladesh, India, Sri Lanka and recently, Thailand. The paan business is famously handled and run by Memon traders, who migrated from western India when Pakistan was created in 1947. To explain the popularity level that the paan is sold at, rough estimates show that an average Pakistani can consume up to 7-8 paans a day.
The chewing of the paan is part of the Khmer culture. Cultivation of Areca nut palm and betel leaves is common in rural areas of Cambodia. In the present times many young people have given up the habit in the urban areas, but many older people still keep it up.
In Vietnam the areca nut and the betel leaf are such important symbols of love and marriage that in Vietnamese the phrase "matters of betel and areca" (chuyện trầu cau) is synonymous with marriage. Areca nut chewing starts the talk between the groom's parents and the bride's parents about the young couple's marriage. Therefore the leaves and juices are used ceremonially in Vietnamese weddings.