Chien-Hung Lee, Chien and Albert Min-Shan Ko, Albert and Saman Warnakulasuriya, Saman and Tian-You Ling, Tian and Sunarjo, Sunarjo and Palandage Sunethra Rajapakse, Palandage and Rosnah Binti Zain, Rosnah and Salah Osman Ibrahim, Salah and Shan-Shan Zhang, Shan and Han-Jiang Wu, Han and Lin Liu, Lin and Kuntoro, Kuntoro and Budi Utomo, Budi and Supun Amila Warusavithana, Supun and Ishak Abdul Razak, Ishak and Norlida Abdullah, Norlida and Prashanta Shrestha, Prashanta and Tien-Yu Shieh, Tien and Cheng-Fang Yen, Cheng and Ying-Chin Ko, Ying Population Burden of Betel Quid Abuse and Its Relation to Oral Premalignant Disorders in South, Southeast, and East Asia: An Asian Betel-Quid Consortium Study. American Journal of Public Health, 102 (3). pp. 1741-1751. ISSN P-ISSN:0090-0036; E-ISSN:1541-0048

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Abstract

Abstract Objectives: We investigated the population burden of betel quid abuse and its related impact on oral premalignant disorders (OPDs) in South, Southeast, and East Asia. Methods: The Asian Betel-Quid Consortium conducted a multistage sampling of 8922 representative participants from Taiwan, Mainland China, Malaysia, Indonesia, Nepal, and Sri Lanka. Participants received an interviewer-administered survey and were examined for oral mucosal disorders. Results: The prevalence of betel quid abuse was 0.8% to 46.3% across 6 Asian populations. The abuse frequency was over 40.5% for current chewers, with the highest proportion in Nepalese and Southeast Asian chewers (76.9%-99.6%). Tobacco-added betel quid conferred higher abuse rates (74.4%-99.6%) among Malaysian, Indonesian, and Sri Lankan men than did tobacco-free betel quid (21.8%-89.1%). Gender, lower education level, younger age at chewing initiation, and clustering of familial betel quid use significantly contributed to higher abuse rates. Indonesian betel quid abusers showed the highest prevalence of OPDs and had a greater risk of OPDs than did nonabusers. Conclusions: Betel quid abuse is high in regions of Asia where it is customarily practiced, and such abuse correlates highly with OPDs. By recognizing abuse-associated factors, health policies and preventive frameworks can be effectively constructed to combat these oral preneoplasms.

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