The areca nut is the fruit of the areca palm (Areca catechu), which grows in much of the tropical Pacific (Melanesia and Micronesia), Southeast and South Asia, and parts of east Africa. This fruit is commonly referred to as betel nut so it is easily confused with betel (Piper betle) leaves that are often used to wrap it (paan). The term areca originated from the Malayalam word adakka (അടക്ക) and dates from the 16th century, when Dutch and Portuguese sailors took the nut from Kerala to Europe. Consumption has many harmful effects on health and is carcinogenic to humans. Various compounds present in the nut, most importantly arecoline (the primary psychoactive ingredient which is similar to nicotine), contribute to histologic changes in the oral mucosa. As with chewing tobacco, its use is discouraged by preventive efforts.