In multiple studies, arecoline was shown to downregulate tumor suppressor activities, such as reduced miR-22, miR211-TCF12, miR329, miR410, miR-379, miR-30a, miR483-5p, and miR-886-3p and to upregulate the proto-oncogenes ADHFE1, ALDH1A2, and DDR-1, which are associated with increased cell proliferation and anti-apoptosis [22,31,32,51,76,81]. This evidence concerns the gene ALDH1A2 and neoplasm.