What Motivates Betel Quid Chewers to Quit? An Analysis of Several Cessation-Relevant Variables

Abstract

Introduction: Betel quid (BQ) is globally the fourth most consumed psychoactive substance. It is consumed by an estimated 600 million people worldwide, accounting for nearly 8% of the world’s population. There have been very few studies assessing chewers’ motivation to quit. Objectives: In the current study, we sought to understand the relationship between several cessation-relevant variables and chewers’ motivation to quit. Hypotheses: Based on analogous research on cigarette smoking, we hypothesized that the following cessation-relevant variables would be associated with motivation to quit: health risk perceptions, number of chews per day, cost, degree of BQ dependence, withdrawal symptoms, number of quit attempts, reasons for use, personal health improvement, and type of BQ chewed. Methods: A total of 351 adult BQ chewers from Guam participated in the survey and served as the sample for the analyses. Results: Majority of chewers want to quit and intend to quit. Chewers relatively high in motivation to quit evinced greater health risk perceptions of BQ chewing, greater perceived health benefits to quitting, and a greater number of past quit attempts, compared to those relatively low in motivation to quit. Conclusions: Understanding which factors are associated with chewers’ motivation to quit can be helpful for designing BQ cessation programs. The results suggest that BQ cessation programs could be improved by an increased emphasis on information about the negative health effects of BQ chewing and relapse-prevention.

Keywords:

• Areca nut
• betel quid
• betel nut
• motivation to quit
• cessation-relevant variables
• health risk perception
• quit attempts
• reasons for use

Authors’ contributions

KA, TH, and PP performed statistical analyses and wrote sections of the manuscript. SE and SI wrote sections of the manuscript. TH and KM wrote the study protocol and contributed to the study survey design. All authors contributed to and have approved the final manuscript.

Declaration of interest

The authors report there are no competing interests to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author, TH, upon reasonable request.

Additional information

Funding

This work was supported by the National Cancer Institute under grant number 1U54CA143728 & 1U54CA143727. KA was supported by a grant from the National Cancer Institute (R25 CA244073).