Indonesians, like other Southeast Asians, have been extensive users of mild narcotic analgesics throughout history. Until a century ago the most widespread narcotic was the chewed quid of betel, comprising the areca nut, betel leaves, lime, and sundry optional additives. Europeans introduced both tobacco and opium around 1600, and Indonesians quickly took up the growing of tobacco. Initially smoked by a relatively small elite, tobacco became used almost universally as part of the betel chew by the end of the eighteenth century. At the end of the nineteenth century cigarette-smoking for men became associated with the transformation to “modern” attitudes, and it rapidly replaced betel-chewing. Today virtually all Indonesian men smoke and virtually none chew betel. Among women betel-chewing has no such substitute and is disappearing more slowly.

Tobacco has relaxant and sedative effects similar to betel. Whereas the betel ingredients were very cheap, tobacco now consumes about 5 percent of the incomes of Indonesian families, including the poorest. Although betel-chewing provided protection against tooth decay, intestinal parasites, and bacteria, tobacco-smoking is injurious to health in a variety of ways.

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