The World Health Organisation says the growing prevalence of betel nut chewing in Melanesia and Micronesia is leading to a rise in oral cancer.
The WHO has found that in Palau 63 percent of middle school and 75 percent of high school students have chewed betel nut and the majority of high school students have chewed it with tobacco.
The WHO's expert on non-communicable diseases Dr Temo Waqanivalu says betel nut chewing is becoming more popular, mostly in Micronesia and this is leading to greater health concerns.
"We've seen some correlating increase in mouth cancers as a result of this increase in chewing. Also because it is quite closely related with tobacco chewing or tobacco smoking for that matter."
Dr Waqanivalu says betel nut chewing is becoming more deadly as there is an increasing trend in adding tobacco, which is carcinogenic.