A study on betel quid chewing behavior and its socioeconomic associations among adults in Myanmar : data from Myanmar demographic and health survey 2015-2016

Abstract

Betel quid is defined as a mixture of various substances, such as betel leaf, areca nut, slaked lime, and with or without tobacco. It causes various types of cancers in humans such as, oral cancer. Although there are several small scale studies in Myanmar, to my knowledge, this is the first study to investigate betel quid chewing habits using a nationally representative sample in Myanmar. The objective of this study is to study betel quid chewing habits in terms of betel quid use and the consumption levels among adults in Myanmar. This study is a cross-sectional, secondary data analysis design of Myanmar Demographic and Health Survey (2015-2016) with a total of 11,773 women and 4,251 men aged 18-49 years. The outcome variables were i) betel quid chewing (yes or no) and ii) number of pieces of betel quid chewing per day categorized into four consumption levels (0, 1-2, 3-5, 6+). Independent variables were sociodemographic factors and tobacco. Chi-square tests, binary and multinomial logistic regression were performed with p-value < 0.05 as a significance. The prevalence of chewing was 61.6% in men, and 22.1% in women. A substantial variation by 15 regions was found. In multivariate analysis, low education, occupation, low family wealth, married, most regions were positively associated in both genders, while older and jobless men were inversely associated, Older age and tobacco use were positively associated in only women. Men averagely chewed 5.59 pieces (SD=8.229) per day while women chewed 1.25 pieces (SD=3.584). The prevalence of chewing daily pieces 1-2, 3-5, and 6+ were 7.9%, 17.1%, and 34.2 % for men and 6.1%, 8%, and 7.1%, respectively, for women. Low education, low family wealth, married, and urban were more likely to chew 6+ pieces, relative to no consumption in both genders, while there was a positive association with age only in women. Tobacco use was positively associated with 1-2 pieces in both genders. In conclusion, this study shows a large disparity in prevalence of chewing between genders and between regions. The government should implement culturally sensitive intervention and policies including effective health promotion campaigns to reduce betel quid chewing. IMPLICATION OF THESIS. Suggestions for further research 1.This study suggests the need of further studies on the regional variations to better understand the problems. 2.Future study is needed to identify the association of betel quid chewing with duration and initiation time of betel quid, and other characteristics related to betel quid chewing.