Betel Quid Dependency and Associated Intrapersonal, Interpersonal, and Environmental Factors among Adolescents: A School-Based Cross-Sectional Survey

ABSTRACT

Background: Betel quid (BQ) is one of the fourth most commonly used substance globally. Though BQ is a psycho-active substance, yet little has been explored regarding dependency on it particularly among adolescents. Objectives: Therefore, in this study, we aimed to determine adolescents' dependency on BQ, along with their intrapersonal, interpersonal and environmental determinants of dependency. Methods: This cross-sectional study focused on 2200 school-going adolescents of Karachi, Pakistan in 2016. Primary outcome was dependency on BQ among adolescents. Both univariate and multivariate regressions were used to estimate crude and adjusted odds ratios (after adjustments for all intrapersonal, interpersonal, and environmental factors) with 95% confidence level. Results: Out of 2200 students, 874 (39.7%) were found to be BQ users amongst whom 69 (7.9%) were dependent on BQ. Comparing the groups with only areca nut users as reference category, betel quid with tobacco additives chewers were considerably dependent (OR = 14.08, 95% CI 3.64–54.16). The individuals who chewed >5 chews per day (OR = 1.87, 95% CI 1.08–3.29) and chronic users (>1year) (OR = 2.02, 95% CI 1.09–3.74) were more likely to be dependent. Older students (>12 years) (OR = 2.12, 95% CI 1.06–4.23), and who studied in government schools were significantly dependent (OR = 3.32, 95% CI 1.80–6.10) than those who studied in private schools. Conclusions: In conclusion, intrapersonal characteristics like more than 5 chews per day, chronic chewers of more than a year, BQ with tobacco chewers, older adolescents and children studying in government schools were significantly associated with BQ dependency.

KEYWORDS:

• Betel quid
• dependency
• betel quid dependence scale
• adolescents
• dependency determinants

Author's contributions

KS and AH comprehended the basic theme of the work, AH sorted all approvals and collected the data, AH ran the analysis with statistical support from SZ, both AH and SZ interpreted the results, KS supervised throughout the project and in drafting of manuscript.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.