Social and Cultural Context of Betel Quid Consumption in Taiwan and Implications for Prevention and Cessation Interventions.

BACKGROUND: In Taiwan, betel quid chewing is a part of social life for chewers. Betel quid itself, with or without tobacco, is a Group 1 human carcinogen. Betel quid chewing has become a severe health threat in Taiwan. OBJECTIVES: The aim of the present study was to identify the individual, social, contextual, and cultural factors related to initiation, continuous use, and cessation of betel quid chewing. METHODS: Four focus groups and 15 in depth face-to-face interviews were conducted in 2013 with current and former users of betel quid, members of a community organization located in central Taiwan. A thematic analysis identified themes evident across all groups. RESULTS: Study participants (N = 41) were 66% male and 34% female; mean age was 40.34 ± 9.23 years. Participants stated that betel quid initiation usually occurs during childhood and that the most frequent reasons for chewing were: to follow cultural/social traditions, to achieve an energetic feeling, and to avoid boredom. Participants perceived betel quid chewing as an addiction and a risk factor for cancer and other health-related conditions. The most frequently mentioned barriers to quitting betel quid included: peer pressure and selected withdrawal symptoms. CONCLUSIONS: For the development of culturally relevant and effective cessation interventions for betel quid in Taiwan, it is critical to understand and address perceptions of betel quid chewing and barriers to cessation.

A pilot study to assess tobacco use among sexual minorities in Houston, Texas.

BACKGROUND AND OBJECTIVES: To assess tobacco use among lesbian, gay, bisexual, and transgender (LGBT) individuals from the 2014 Houston Pride Parade and Festival in Houston, Texas (TX). METHODS: Cross-sectional study using convenience sample of LGBT individuals (n = 99) examining tobacco use, sexual orientation, and other socio-demographic factors through survey participation. RESULTS: Findings showed a high prevalence of tobacco and electronic cigarettes use. White LGBT individuals had greater odds of using any type of tobacco product. DISCUSSION AND CONCLUSIONS: Despite a high smoking prevalence among the surveyed LGBT individuals, this study sample did not identify tobacco use as a health issue. SCIENTIFIC SIGNIFICANCE: Supports the need for further investigation on tobacco-related disparities among LGBT individuals in Houston, TX.

The social norms and beliefs of teenage male electronic cigarette use.

Electronic cigarettes (e-cigarettes) are novel, battery-operated inhalation devices that provide warm, vaporized nicotine, and often propylene glycol, to users without the inclusion of tobacco smoke. Because men, in general, are more likely to use cigarettes and illicit drugs than women, a qualitative study was undertaken to investigate the beliefs and perceived social norms regarding this issue among 47 teenage boys who self-identified themselves as current e-cigarette smokers. The majority of respondents reported that they used e-cigarettes because of expeditious consumption and concealment. Furthermore, the most common places respondents self-reported using e-cigarettes were everywhere, in school bathrooms, at home, and in school staircases. Interestingly, respondents stated that e-cigarettes are popular because they are accessible, healthier than tobacco cigarettes, and more aesthetically pleasing. Because of the growing popularity and uncertainty regarding the social and physical consequences of e-cigarettes, this study shows a need for additional research discovery.

A qualitative study of attitudes to and perceptions of betel quid consumption and its oral health implications in Taiwan.

OBJECTIVES: Betel quid (BQ) chewing is extremely prominent in South and Southeast Asia because it considered by users to be of social, cultural and religious importance. BQ chewing has been recognized as a risk factor for oral premalignant lesions and oral cancer. Because BQ chewing has become a severe health risk in Taiwan, the development of prevention and cessation programmes is essential. The purpose of this study was to explore the attitudes and perceptions associated with BQ consumption and its oral health implications in an attempt to inform the development of health promotion initiatives and BQ cessation efforts in Taiwan, where the dental profession could have a pivotal role in preventing and controlling BQ use among persons at risk. METHODS: This qualitative study used data gathered from focus groups and individual interviews. A convenience sample of 41 adults from Jhushan and Lugu Townships (Nantou County) and Taichung City, Taiwan, participated in this study (27 men, 14 women; 31 Han, 10 aboriginals from the Paiwan tribe; mean age 40.3, SD 9.2 years). RESULTS: Among the seven themes that emerged from the original study, five (Initiation, Health Risk Perception, Health Consequences, Withdrawal Symptoms and Help from Healthcare Providers) had oral/dental implications. CONCLUSIONS: Our study highlights research areas relevant to further investigation, such as incorporating brief BQ prevention and cessation counselling when early oral and dental signs associated with BQ consumption are detected. Undertaking behavioural interventions in dental settings might help to reduce the prevalence of BQ chewing in Taiwan.