The Emerging threat of betel quid in the United States

Objectives: Betel quid (BQ) is consumed by approximately 10% of the world’s population, many of whom reside in the geographical areas of South and South East Asia. BQ is generally a combination of betel leaf, slaked lime, and processed areca nut with tobacco often added. Additional food ingredients may include: spices, seeds, sweeteners, coconut, etc. BQ use with or without smokeless tobacco is highly associated with oral submucous fibrosis, oral cancer, and oral premalignant lesions. The impact of BQ use in the United States (US) is largely unknown, but the products are readily available and probably used by a significant fraction of Asian immigrants or descendants living in the US. The purpose of our study was to assess BQ use prevalence, as well as BQ purchase patterns, among different Asian groups residing in Houston, Texas.
Methods: A cross-sectional questionnaire was used to interview adult individuals (≥18 years of age) who self-identified as Asian immigrants or descendants. Percentages were used to describe categorical variables in our sample.
Results: Our sample consisted in 83 participants: 61% females, 51% between 18 and 44 years old. Almost three quarters of our sample (73%) were born outside the US: 37% Philippines, 23% Vietnamese, 13% Chinese, 12% Indian, and 15% other. About 10% of the respondents have used BQ and 25% knew about friends/family members living in the US who use BQ. Thirty five percent of the respondents reported to have seen BQ products at Asian stores in the US. Only 21% associate BQ consumption with cancer.
Conclusions: Findings from our study will provide useful information for implementing future BQ prevention and cessation interventions especially designed for the US, as this is crucial in the prevention and control of oral cancer, particularly among this vulnerable Asian populations.