Areca Nut Dependence Among Chewers in a South Indian Community Who Do Not Also Use Tobacco
Authors
Shrihari MPH.
Clinical Research Specialist, Care Management International, Nyati Millennium, Viman Nagar, Pune, Maharashtra 410014
Melissa Ph.D.
Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
Robert Ph.D.
Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Box 980310, Richmond, VA 23298-0310
Mimi Ph.D.
Department of Anthropology, University of Arizona, Box 210030, Tucson, AZ, 85721-0030
Mark MPH
Department of Anthropology, University of Arizona, Box 210030, Tucson, AZ, 85721-0030
Keywords:
Areca, Betel, Dependence, Topography
Abstract
Aims
The goal of this study was to examine evidence of areca dependence in a large, representative sample of areca-only (i.e., no tobacco) chewers using established measurement scales. Information was also gathered on use patterns in this population.
Methods
Daily chewers (N=59) from Karnataka State, India were surveyed in 2005. Questionnaires assessed chewing history, patterns of use, and dependence features. Additionally, the relationship between topography and dependence scores was evaluated.
Results
Approximately half of respondents reported 1–3 chews/day (mean = 1.9; SD = 0.98). The average number of chewing episodes/day was 4.4 (SD = 3.4) and the average number of nuts/day was 1.2 (SD = 1.1). Users’ typical chew lasts up to 20 minutes and includes spitting out the juices and rinsing the mouth with water. Overall, the levels of reported dependence symptoms were low, but approximately 44% of chewers endorsed at least one of the following items: continued use despite illness or wounds, difficulty refraining from chewing in forbidden places, or craving during periods of abstinence. Approximately 15% of chewers reported at least one quit attempt, and 13.6% had scores indicative of dependence on the modified Cigarette Dependence Scale (Score >16). Dependence scores were positively correlated with frequency of use.
Conclusions
High levels of dependence were not observed in this sample of regular betel-only users, but many users reported at least one symptom and a few had several symptoms. The levels of dependence observed in a subset of informants’ warrant further investigation as evidence for possible betel dependence.
Keywords: Areca, Betel, Dependence, Topography
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