title: Alcohol, betel-nut and cigarette consumption are negatively associated with health promoting behaviors in Taiwan: a cross-sectional study.
abstract: BACKGROUND
  Oral cancer is the 2nd most common cause of death due to cancer in the south-western coastal region of Taiwan; the standardized mortality of oral cancer is higher than elsewhere in the world. According to the evidence, alcohol, betel-nut and cigarette (ABC) consumption cause oral, nasopharyngeal and related cancers. This study describes the relationships between ABC consumers and health promoting behaviors among community adults living around an area with a high prevalence of oral cancer.
  
  
  METHODS
  A population-based, cross-sectional study design was conducted in oral cancer epidemic areas in south-western coastal Taiwan in 2010, 6,203 community residents over 20 years of age participated. Demographic data, ABC habits, and health-promoting behaviors were explored. A logistic regression analyses were used to identify factors associated with ABC consumers.
  
  
  RESULTS
  A high percentage of participants consumed alcohol, betel-nut and cigarettes. Betel-nut and cigarette consumers took low levels of exercise, adopted a poor diet, and had poor oral hygiene. After adjusting for potential confounders, the logistic regression model indicated that middle aged males of poor education and low economic status, who did not exercise regularly and had poor oral hygiene, were more likely to chew betel quid and smoke cigarettes.
  
  
  CONCLUSIONS
  It has identified that BC consumers are negatively associated with health promoting behaviors. Further research is required to understand the reasons why the subjects consume ABC, and explore ways to prevent initiation and enhance cessation of ABC habits in this population.
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology(CGUST), Putz City, Chiayi County 61363, R.O.C. Taiwan.
authors.forename: Su-Er
authors.initials: SE
authors.lastname: Guo
authors.forename: Tung-Jung
authors.initials: TJ
authors.lastname: Huang
authors.forename: Jui-Chu
authors.initials: JC
authors.lastname: Huang
authors.forename: Ming-Shyan
authors.initials: MS
authors.lastname: Lin
authors.forename: Rei-Mei
authors.initials: RM
authors.lastname: Hong
authors.forename: Chia-Hao
authors.initials: CH
authors.lastname: Chang
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D001114:Areca; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult