title: Intention to quit betel quid: a comparison of betel quid chewers and cigarette smokers.
abstract: BACKGROUND
  Despite the global significance of betel quid chewing and the associated health risks, there have been no studies assessing chewers' intention to quit. Given the difficulties associated with quitting betel quid and the serious health consequences of chewing, it is important for researchers to develop interventions aimed at helping chewers quit. Betel quid chewers experience similar patterns of dependence and withdrawal symptoms as tobacco smokers, and the use of both substances causes serious adverse health effects. Therefore, it is possible that intention to quit betel quid and tobacco would also be similar. If similarities were found, researchers could look to existing tobacco cessation interventions to inform the development of betel quid cessation interventions. In the current study we sought to understand chewers' intention to quit and how it compares to smokers' intention to quit cigarettes.
  
  
  METHODS
  A total of 351 adult betel quid chewers from Guam were compared against 1,555 adult tobacco users from Hawaii. These comparisons were made possible because of the deliberate use of identical questionnaire items (mutatis mutandis) for betel quid chewing and cigarette smoking.
  
  
  RESULTS
  Smokers reported higher levels of wanting to quit, intending to quit, and wishing they have never started in the first place compared to chewers (p's<.0001). There were no differences across groups with regard to having a plan for how to quit and when to quit, with half of the samples reporting not having a plan for how or when to quit.
  
  
  CONCLUSIONS
  Both smokers and chewers want to quit and intend to quit, but do not have plans of when or how to quit. A deeper understanding of chewers' intention to quit and its similarities to smokers' intention to quit could be used to inform the development of betel quid cessation interventions.
authors.affiliation: University of Hawaii Cancer Center, Epidemiology Program, 701 Ilalo St., B5, Honolulu, HI 96813, USA; Tel: 808-564-5832; Fax: 808-586-3077; e-mail: mlittle@cc.hawaii.edu.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Little
authors.forename: Pallav
authors.initials: P
authors.lastname: Pokhrel
authors.forename: Kelle L
authors.initials: KL
authors.lastname: Murphy
authors.forename: Crissy T
authors.initials: CT
authors.lastname: Kawamoto
authors.forename: Gil S
authors.initials: GS
authors.lastname: Suguitan
authors.forename: Thaddeus A
authors.initials: TA
authors.lastname: Herzog