title: Patterns of Betel Quid, Cigarette, and Alcohol Use, and Their Correlates With Betel Quid Cessation in a Male Inmate Population.
abstract: BACKGROUND
  There are few published studies addressing multiple substance uses and their effects on subsequent cessation of betel quid (BQ) chewing in the Asia Pacific region.
  
  
  OBJECTIVE
  This study aims to investigate the usage patterns of BQ chewing, cigarette smoking, and alcohol drinking, and their correlates with subsequent BQ cessation among a male inmate population.
  
  
  METHODS
  Data from 473 male inmates with a history of BQ use who were incarcerated in Taiwan Kaohsiung Prison was used for this analysis. Participants were asked to report their lifetime usage patterns of cigarette, alcohol, and BQ, and their cessation status of each substance. A stepwise logistic regression analysis was performed to identify predictors of voluntary BQ cessation.
  
  
  RESULTS
  Seventy-five percent of all participants reported habitual use of all three substances. A total of 185 (39%) participants reported voluntary cessation of BQ prior to incarceration, and 288 (61%) reported cessation because of incarceration. Inmates who quit smoking before incarceration were more likely to voluntarily quit BQ. Inmates who had drinking habits were less likely to quit BQ, but those who quit drinking before incarceration were more likely to quit BQ. Inmates who preferred the type of BQ known as lao-hwa quid were more likely to quit BQ, and a longer chewing history correlated with a lower likelihood of quitting BQ. CONCLUSIONS IMPORTANCE: Our data suggest that coexisting habitual use of cigarette, alcohol, and BQ is very common in this inmate population. BQ cessation is significantly associated with not only inmates' usage patterns of cigarette and alcohol, but also their cessation status of these substances.
authors.affiliation: a Department of Oral Hygiene , Kaohsiung Medical University , Kaohsiung , Taiwan.
authors.forename: Chen-Yi
authors.initials: CY
authors.lastname: Lee
authors.affiliation: b Cancer Epidemiology Program, H. Lee Moffitt Cancer Center & Research Institute , Tampa , Florida , USA.
authors.forename: Beibei
authors.initials: B
authors.lastname: Lu
authors.affiliation: c Department of Dentistry , Taipei Medical University , Kaohsiung , Taiwan.
authors.forename: Tien-Yu
authors.initials: TY
authors.lastname: Shieh
authors.affiliation: d Department of Public Health , Kaohsiung Medical University , Kaohsiung , Taiwan.|e Department of Healthcare Administration & Medical Informatics , Kaohsiung Medical University , Kaohsiung , Taiwan.
authors.forename: Yong-Yuan
authors.initials: YY
authors.lastname: Chang
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D001114:Areca; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008409:Mastication; D011329:Prisoners / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Cigarette smoking; alcohol drinking; areca nut; betel quid chewing; cessation; inmate