Biobehavioral and Cultural Determinants of Betel Quid Chewing, Dependence, and Withdrawal in Taiwan
Condition: Smoking; Betel Nut
Study type: Observational

Summary: 
      Cancer of the oral cavity is one of the fastest growing cancers among men in Taiwan. Previous
      research has established a strong link between betel quid chewing, a common practice among
      Taiwanese men, and oral cancer. However, despite the strong association, no attempt has been
      made to develop behavioral measures to facilitate betel quid cessation. This application
      extends upon existing collaboration between MD Anderson and China Medical University Hospital
      (CMUH) and seeks to characterize betel quid chewers and their withdrawal symptoms, in order
      to address an urgent cancer epidemiology issue in Taiwan.
    

Detailed description: 
      Cancer of the oral cavity is one of the fastest growing cancers among men in Taiwan. Previous
      research has established a strong link between betel quid chewing, a common practice among
      Taiwanese men, and oral cancer. However, despite the strong association, no attempt has been
      made to develop behavioral measures to facilitate betel quid cessation. This application
      extends upon existing collaboration between MD Anderson and China Medical University Hospital
      (CMUH) and seeks to characterize betel quid chewers and their withdrawal symptoms, in order
      to address an urgent cancer epidemiology issue in Taiwan. In a two phase study, we will use a
      qualitative approach (guided focus group and interviews), followed by assessment of betel
      quid withdrawal in current chewers: 1) 47 participants will be invited to participate in a
      qualitative study that includes focus group and in-depth structured interviews that examine
      the social and cultural context that surrounds continued use and cessation of betel quid
      consumption, 2) 30 male and female healthy individuals who currently both chew betel quid and
      smoke cigarettes will be invited to attend 4 separate sessions at CMUH and complete a
      self-report questionnaire specifically designed to measure betel quid withdrawal symptoms,
      and the relationship between betel quid chewing and cigarette smoking withdrawal. This
      application represents the first step in the development of a multi-phase, multidisciplinary
      betel quid chewing research program. This program will enhance our understanding of the
      cultural and bio-behavioral aspects of betel quid chewing. Furthermore, it will lead to
      translational research projects that link behavioral findings to clinical treatments, and the
      eventual creation of a large scale, population-based prevention and education program.
    

Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        1. 47 participants will be invited to participate in a qualitative study that includes
             focus group and in-depth structured interviews that examine the social and cultural
             context that surrounds continued use and cessation of betel quid consumption.

          2. 30 male and female healthy individuals who currently both chew betel quid and smoke
             cigarettes will be invited to attend 3 separate sessions at CMUH and complete a
             self-report questionnaire specifically designed to measure betel quid withdrawal
             symptoms, and the relationship between betel quid chewing and cigarette smoking
             withdrawal. This application represents the first step in the development of a
             multi-phase, multidisciplinary betel quid chewing research program.
      
Biospecimen description: 
      The urine of participants for self-report questionnaire study will be retained
    
Keywords: betel nut; dependence; withdraw; deprivation test