title: Chewing of betel quid: why do health careproviders in Thimphu, Bhutan, do it?
abstract: OBJECTIVE
  This cross-sectional study aimed to determine the prevalence of betel quid chewing and related factors including general characteristics, behavioral pattern, perception and social influences among health care providers in Thimphu, Bhutan.
  
  
  METHODS
  A self-administered questionnaire was handed to 478 health care providers working in different units of health care centers in Thimphu during June-July 2010. A total of 391 (81.8%) questionnaires were returned. Chi-square test and multiple logistic regression were applied.
  
  
  RESULTS
  The prevalence of current betel quid chewers among this group was 26.6%. Males chewed betel quid more than females (29.5%, 23.9% respectively). Forty-two percent of current chewers had no specific reasons for chewing betel quid, although 18.2% declared that they were addicted. Both friends and family members were key persons involved in influencing betel quid chewing. Marital status was significantly associated with betel quid chewing, married health care providers being 2 times more likely to chew betel quid (OR = 2.09, 95% CI = 1.02-4.28) than those of single marital status. Similarly, those coming from West Bhutan, were 2 times more likely to be currently using betel quid (OR = 2.71, 95% CI = 1.32-5.55) than other regions. Health care providers from families with more than half of their members chewing betel quid were 14 times more likely to be currently chewing it (OR = 14.52, 95% CI = 6.02-35.04) than families having none of their members chewing it. Health care smokers were more likely to chew betel quid than non-smoking ones (p-value = 0.012). Also occasional drinkers were 3 times more likely to be currently using betel quid (OR = 3.52, 95% CI = 1.78-6.96). Those who perceived a high barrier to quit chewing were about 2.6 times more likely to be current chewers of betel quid, than those who perceived less of a barrier to quit (OR = 2.62, 95% CI = 1.21-5.67).
  
  
  CONCLUSIONS
  The present study revealed betel quid chewing prevalence rate of 26.6%. Of the various factors considered under study, marital status, region of origin, family members chewing betel quid, status of smoking and drinking were statistically proven significant.
authors.affiliation: Royal Institute of Health Sciences, Royal University of Bhutan, Thimphu, Bhutan.
authors.forename: Nidup
authors.initials: N
authors.lastname: Dorji
authors.forename: Oranut
authors.initials: O
authors.lastname: Pacheun
authors.forename: Chaweewon
authors.initials: C
authors.lastname: Boonshuyar
mesh_terms: D000328:Adult; D001631:Bhutan; D017028:Caregivers; D005260:Female; D006184:Habits; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D031721:Piper betle; D053149:Plant Gums; D013785:Thailand
chemical_list: D053149:Plant Gums