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

Chien Hung Lee, Albert Min Shan Ko, Saman Warnakulasuriya, Tian You Ling, Sunarjo, Palandage Sunethra Rajapakse, Rosnah Binti Zain, Salah Osman Ibrahim, Shan Shan Zhang, Han Jiang Wu, Lin Liu, Kuntoro, Budi Utomo, Supun Amila Warusavithana, Ishak Abdul Razak, Norlida Abdullah, Prashanta Shrestha, Tien Yu Shieh, Cheng Fang Yen, Ying Chin Ko

Research output: Contribution to journalArticlepeer-review

54 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)e17-e24
JournalAmerican Journal of Public Health
Volume102
Issue number3
DOIs
Publication statusPublished - Mar 2012

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