Areca (betel) nut chewing practices of adults and health behaviors of their children in the Freely Associated States,Micronesia: Findings from the Children’s Healthy Living (CHL) Program |
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| Institution: | 1. School of Nursing and Health Sciences, Room 103, University of Guam, Mangilao, GU 96923, United States;2. Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, United States;3. College of Tropical Agriculture and Human Resources, University of Hawai‘i at Manoa, Honolulu, HI 96822, United States;4. University of Hawai‘i Cancer Center, 701 Ilalo St., Honolulu, HI 96817, United States;5. Chuuk State Division of Public Health, P.O. Box 400, Weno, Chuuk State 96942, Federated States of Micronesia;6. Comprehensive Cancer Control Program Department of Health Services, P.O. Box 127, Tofol, Kosrae, 96944, Federated States of Micronesia;7. Palau Community College, Koror, 96940, Palau;8. Island Food Community of Pohnpei, Pohnpei, 96941, Federated States of Micronesia;9. P.O. Box 686, Majuro, MH 96960, Marshall Islands;10. P.O. Box 393, Colonia Yap, 96943, Federated States of Micronesia;1. Centre for Public Health Research, Massey University-Wellington Campus, PO Box 756, Wellington 6140, New Zealand;2. Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia;3. National Advisor NCD, Head of National Wellness Centre, Ministry of Health & Medical Services, Fiji;4. John A. Burns School of Medicine, University of Hawaii, University of Hawaii Cancer Center,677 Ilalo Street, Honolulu, HI 96813, United States;1. Faculty of Health Sciences of the University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal;2. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden;3. Department of Statistics, Örebro University, 701 82, Örebro, Sweden;4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE 171 77, Stockholm, Sweden;5. Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, SE 171 76 Stockholm, Sweden;6. Department of Epidemiology and Public Health, University College, WC1E 6BT London, UK;1. Department of Oncology, Queen’s University, Kingston, Canada;2. Department of Surgery, Queen’s University, Kingston, Canada;3. Division of Cancer Care and Epidemiology, Queen’s University Cancer Research Institute, Canada;1. University of Sydney, Australia;2. University of New South Wales, Australia;1. BioForum, Applied Knowledge Center, Ness-Ziona, Israel;2. University of Gerona, Gerona, Spain;1. Registre des cancers du Bas-Rhin, U1113, FMTS, Université de Strasbourg, 4 rue Kirschleger, 67085 Strasbourg, France;2. Service de santé publique, Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67091 Strasbourg, France;3. Registre des cancers de la Manche, Centre Hospitalier Public du Cotentin, 46 rue du Val de Saire, 50102 Cherbourg-Octeville, France;4. Registre des tumeurs de l''Hérault, Centre de Recherche, 208 rue des Apothicaires, 34298 Montpellier, France;5. Registre général des tumeurs du Calvados, Cancers & Préventions – U1086 Inserm, Centre François Baclesse, Avenue du Général Harris BP 5026, 14076 Caen, France;6. Registre des tumeurs du Doubs et du Territoire de Belfort, EA3181, Centre Hospitalier Régional Universitaire, 25030 Besançon, France;7. Registre des cancers du Tarn, 1, rue Lavazière, BP 37, 81001 Albi cedex, France;8. Institut Claudius Regaud, Centre régional de lutte contre le cancer, IUCT-O, Registre des cancers du Tarn, 31059 Toulouse, France;9. Registre des hémopathies malignes de Basse-Normandie, Unité Fonctionnelle Hospitalo-Universitaire n°0350, Centre Hospitalier Universitaire, Avenue de la Côte de Nacre, 14033 Caen, France;10. Registre des cancers de l’Isère, CHU de Grenoble, Pavillon E BP 217, 38043 Grenoble 9, France;11. Registre du cancer de la Somme, Service Épidémiologie Hygiène et Santé Publique, CHU Nord, 80054 Amiens, France;12. Service d’épidémiologie et de biostatistique, Centre Paul Strauss, 3 rue de la Porte de l’hôpital, 67065 Strasbourg, France |
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| Abstract: | BackgroundChewing areca (betel) nut has been deemed carcinogenic. The practice has become a public health concern in Micronesia. The Children's Healthy Living (CHL) Program included an areca (betel) nut questionnaire in a survey of household characteristics in the Freely Associated States (FAS). This paper describes areca (betel) nut chewing practices of adults and the health behaviors of their children.MethodsA cross-section of 1200 children (2–8 year-olds) and their caregivers in Chuuk, Kosrae, Pohnpei, Republic of Palau, Republic of the Marshall Islands (RMI), and Yap were recruited. Socio-demographics, adult areca (betel) nut chewing practices, and other health behaviors of children and adults were assessed. Child anthropometric measurements were collected to estimate weight status.ResultsThe FAS areca (betel) nut chewing prevalence was 42%, ranging from 3% (RMI) to 94% (Yap). Among chewers, 84% added tobacco, 97% added slaked lime, 85% added betel leaf, and 24% mixed the components with alcohol. Among FAS children, 95% practiced daily teeth-brushing and 53% visited the dentist annually. Compared to non-chewing households, areca (betel) nut chewing households were more likely to have very young children enrolled, more highly educated adults, and members that used tobacco and alcohol.ConclusionThe FAS areca (betel) nut chewing prevalence (42%) is above the world prevalence of 10–20%, with wide variability across the islands. The oral health findings in this study may inform future oral cancer prevention programs or policies. Regular monitoring of areca (betel) nut use is needed to measure the impact of such programs or policies. |
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| Keywords: | Alcohol Areca Betel Childhood obesity CHL Micronesia Oral cancer Tobacco |
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