Predictors of betel quid chewing behavior and cessation patterns in Taiwan aborigines

A stratified random community-based survey was designed for the entire aborigines communities in Taiwan. A total of 7144 participants were included between June 2003 and May 2004 in this study. Information on sociodemographic characteristics, such as gender, age, obesity, education years, marital status, ethnicity, and habits of betel quid chewing, smoking and drinking was collected by trained interviewers.The prevalence of betel quid chewers was 46.1%. Betel quid chewing was closely associated with obesity (OR = 1.61; 95% CI: 1.40–1.85). Betel quid chewers were most likely to use alcohol and cigarettes together. Quit rate of betel quid chewers was 7.6%. Betel quid chewers who did not drink alcohol were more likely to quit (OR = 1.89; 95% CI: 1.43–2.50). Alcohol use is a significant factor related to cessation of betel quid chewing, but smoking is not.Taiwan aborigines have a high prevalence of betel quid chewers and a low quit rate. Alcohol use is strongly association with betel quid chewing. Efforts to reduce habitual alcohol consumption might be of benefit in cessation of betel quid chewing.Betel quid consumption is an addictive habit with psychoactive properties, used by an estimated 600 million people worldwide [1-4]. This practice is widespread in Taiwan, with approximately two million habitual users (10% of population) [5]. In 2004, the International Agency for Research on Cancer (IARC) declared chewing of betel quid, by itself, to be a Group 1 carcinogen and the areca nut to be, correspondingly, a Group 1 carcinogen [6]. Chewing betel quid independently contributes to the risk of oropharyngeal cancer [7-9], oral mucosal lesions [10], oral leukoplakia [11], oral submucous fibrosis (OSF) [11], liver cirrhosis [12], hepatocellular carcinoma (HCC) [13], diabetes mellitus [14] and adverse outcomes with use during pregnancy [15,16]. These pertinent health risks highlight the need for cessation of betel quid chewing. Indeed, betel quid chewing is a recognized publi