The World Health Organisation's Tobacco Free Initiative fears young people are beginning to chew betel nut with tobacco from an earlier age.
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 the high schools students have chewed it with tobacco.
A Technical Officer for the Tobacco Free Initiative in the Western Pacific region James Rarick says work is being done to combat the issue through raising taxes and placing warning labels on packaging.
"Obviously not selling tobacco to minors is very big but also not selling single sticks of cigarettes to minors. And this is a real common practice in many of the countries where betel nut is a problem and it's one of the ways that makes it easier for young people to start adding tobacco to the betel nut."
James Rarick says the Tobacco Free Initiative is also limiting the number of tobacco advertisements on television and print media around the Pacific region.