Betel Quid Dependence Effects on Working Memory and Remote Memory in Chewers with Concurrent Use of Cigarette and Alcohol

Abstract

Rationale: Betel quid (BQ) is regarded as a human carcinogen by the World Health Organization. Although there are many BQ chewers across Asian-Pacific areas, studies addressing the effects of BQ chewing on memory remain rare.

Objective

The current study asked whether BQ dependence level could affect working memory (WM) and remote memory for the chewers with concurrent use of cigarettes and alcohol, a common phenomenon in Taiwan.

Methods

The standardized neuropsychological tests (Wechsler Memory Scale III (WMS-III) and Remote Memory Test) were adopted to address the BQ chewers’ verbal WM, spatial WM and remote memory. The Spatial Span Test and the Digit Span Test from WMS-III and the Remote Memory Test were adopted. The Betel Nut Dependency Scale (BNDS), the Fagerstrom Test for Nicotine Dependence (FTND), and the Alcohol Use Disorders Identification Test (AUDIT) were adopted to measure the dependence levels.

Results

The BQ dependence level and Last BQ did not affect spatial WM, verbal WM, and remote memory. Last Cigarette is critical in affecting WM; namely, longer interval led to worse performance. Finally, higher alcohol dependence level could lead to better remote memory.

Conclusions

To our knowledge, there are no BQ studies addressing the effects of concurrent use of cigarettes and alcohol on memory. The current results suggest that cigarette smoking and alcohol drinking, rather than BQ chewing, are critical for memory performance.

Keywords:

• Betel quid
• cigarette
• alcohol
• working memory
• remote memory

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Notes

1 Wyatt (1996) and Chiu et al. (2016). used the term short-term memory (STM), while Osborne et al. (2011). and the current study used the term WM. STM involves domain-specific simple storage and WM involves domain-general central executive for manipulation of stored information Kane et al. (2004) and Wager and Smith (2003). That is, the WM model (storage and manipulation) includes STM (simple storage) Baddeley (2003) and Wager and Smith (2003). Also, there is a highly positive correlation between STM tasks and WM tasks Kane et al. (2004). Finally, the forward recall task may not require only simple storage, but also central executive action for ordering manipulation Bireta et al. (2010) and Wager and Smith (2003). Therefore, we used WM in the current study.

Additional information

Funding

This study was funded by grant KMU-EM-99-1-1 from the Center of Excellence for Environment Medicine, Kaohsiung Medical University; “Aim for the Top Universities Grant” (grants KMU-TP104A13 and KMU-TP105A12) from the Research Center for Environmental Medicine, Kaohsiung Medical University.