If harm-reduction research is going to build on the ancient baseline provided by the Sulawesi evidence, it needs to be clear about which components of the modern practice were present in the ancient one and which were not.

The lime, in particular, is suspected of being a co-carcinogen in the development of oral cancer in modern users.

The ancient foragers, who were not using lime, may have had a different cancer risk profile from modern betel quid users — though the extent of this difference is not established.

The Forty-Five Thousand Year Cave Paintings And The Twenty-Five Thousand Year Teeth

Leang Bulu Bettue is in the Maros-Pangkep karst — the same geological formation and roughly the same geographic area as the caves containing the world’s oldest representational art.