Comparing factors affecting commencement and cessation of betel quid chewing behavior in Taiwanese adults

<p>Abstract</p> <p>Background</p> <p>Betel quid is the fourth most common used substance in the world after tobacco, alcohol and caffeine. Although factors related to betel quid chewing or cessation of behaviors were reported previously, few studies simultaneously compared both behaviors in the same population. In addition, it is essential to consider time-to-event concept, since the chance of developing or stopping habit may vary over time. The purpose of this study was to compare the risk factors for commencement and cessation of betel quid chewing behaviors in a time-to-event setting.</p> <p>Methods</p> <p>A stratified multi-stage cluster sampling with selection probabilities proportional to size (PPS) was designed for Taiwanese adults with aged 18 years old and above. Kaplan-Meier estimates and Cox proportional hazard regression models were used to compare and calculate the hazard rate ratios for related factors to commencement or cessation of chewing habits.</p> <p>Results</p> <p>In Taiwan, men had a higher betel quid chewing rate (M: 20.9%, W: 1.2%), but woman chewers had a lower cessation rate (M: 27.5%, W: 12.7%). The hazard rate ratio (HRR) of having chewing habit changed from 4.22 (men vs women) univariately to 1.38 multivariablely, which indicated gender differences were confounded by other factors. In multivariable analysis, the risk factors of gender, education and ethnicity were significantly associated with both starting and cessation of betel quid chewing behavior. The factors of occupation, cigarette smoking and alcohol drinking were only associated with starting habit.</p> <p>Conclusion</p> <p>Commencement or cessation of chewing behavior involves a scenario of time, hence it is preferable to use a time-to-event approach for the comparison. The cessation rates of betel quid chewing were decreasingly associated with the daily consumption of betel quid. Hence, reducing of daily amount in betel quid cessation program may be associated with future stopping habit.</p

Prevalence and associated factors of betel quid use in the Solomon islands: A hyperendemic area for oral and pharyngeal cancer

[[abstract]]Chewing betel quid is a popular habit in tropical areas. It is also a known fact that oral cancer is one of the most common cancers in the Solomon Islands, where betel quid chewing is prevalent. This study explores the prevalence of betel quid chewing in the Solomon Islands and related sociodemographic factors. A community-based survey was designed for the entire Solomon Islands people. Information on sociodemographic characteristics, habits of betel quid chewing, smoking, and drinking was collected by trained interviewers with a standard questionnaire. The prevalence of betel quid chewers, smokers, and drinkers was 76.8%, 53.0%, and 36.8%, respectively. Betel quid use was closely associated with smoking (aOR = 3.95; 95 % CI: 1.87-8.33). Seventh-Day Adventist subjects were less likely to chew betel quid (aOR = 0.08; 95% Cl: 0.04-0.18). Efforts to reduce habitual betel quid consumption and smoking might be of benefit in reduction of oral cancer incidence