Perceive Stress and Betel Quid Dependence Associated with Reasons for Betel Quid Chewing: A Mixed Methods Study

Abstract

Aims: Social culture concerns and BQ dependence maybe the potential reasons for BQ chewing. This study’s purpose was to identify the correlates of reasons for betel quid (BQ) chewing. Methods: We adopted a mixed-methodsdesign design. The study was conducted between October 2021 and August 2023 at a medical center of northern Taiwan. The Reasons for Betel-Quid Chewing Scale, Numeric Rating Scale, and Betel Quid Dependence Scalewere used to quantitatively assess reasons for betel quid chewing, stress, and betel quid dependence, respectively. Semi-structured questions were used to interview for qualitative data. Results: The most common reasons for betel quid chewing were stimulation, reinforcement, and social/cultural factors. Chewers who reported more pressure to chew were more likely to be younger, have less educational level, be employed, have greater stress, and have more betel quid dependence. Content analysis of qualitative data showed three themes: physical and psychological demands, peer pressure, and perceived greater effectiveness. Conclusion: Employment was the factor most commonly associated with reasons for betel quid chewing and with each construct. Study findings can help healthcare professionals understand reasons for betel quid chewing, thereby helping them educate chewers to cope with withdrawal symptoms and successfully quit.