Determining High Prevalence of Betel-Quid Chewing and Cigarette Smoking by Occupation Using the Taiwan National Health Interview Survey

Abstract

Background: Effectiveness of oral cancer screening depends on identifying high-risk groups. People with betel quid chewing or cigarette smoking habits are often reluctant to attend screenings. Given that use of both substances is associated with certain occupations, a targeted approach should be applied to improve the effectiveness of screening programs. Objectives: This study sought to identify occupations with a high prevalence of betel quid chewing and cigarette smoking and to investigate their changing trends using the Taiwan National Health Interview Survey (NHIS) database. Methods: The NHIS database for 2009 and 2013 were used. We estimated prevalence of current betel quid and/or cigarette use among those aged 20-64 years old. Occupations were classified using the International Standard Classification of Occupations (ISCO-88). Statistical analyses included indirect standardized rates and cluster analysis of chewing/smoking habits. Results: Drivers, mobile-plant operators, and extraction and building trades workers had the highest prevalence of betel quid chewing and cigarette smoking (chewing: 30.92% and 29.62%; smoking: 61.16% and 62.22%). Many occupations had large indirect standardized rates for chewing but not smoking. Both habits are associated with each other (r = 0.81, p < 0.001). Use appeared to decrease based on comparison between 2009 and 2013. Conclusions: Drivers and construction laborers showed high prevalence of betel chewing and cigarette smoking. The chewing habit is actually more prevalent in several sub-occupations. The survey results also revealed lower attendance by construction laborers at oral cancer screenings. Oral cancer screening and awareness should be emphasized in the identified occupations.

Keywords:

• Betel quid
• smoking
• occupation
• screening
• oral cancer
• oral potentially malignant disorders

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is funded by the Health Promotion Administration, Ministry of Health and Welfare, Taiwan (Grant: A1060305).