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Published in: BMC Oral Health 1/2014

Open Access 01-12-2014 | Research article

The reasons for betel-quid chewing scale: assessment of factor structure, reliability, and validity

Authors: Melissa A Little, Pallav Pokhrel, Kelle L Murphy, Crissy T Kawamoto, Gil S Suguitan, Thaddeus A Herzog

Published in: BMC Oral Health | Issue 1/2014

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Abstract

Background

Despite the fact that betel-quid is one of the most commonly used psychoactive substances worldwide and a major risk-factor for head-and-neck cancer incidence and mortality globally, currently no standardized instrument is available to assess the reasons why individuals chew betel-quid. A measure to assess reasons for chewing betel-quid could help researchers and clinicians develop prevention and treatment strategies. In the current study, we sought to develop and evaluate a self-report instrument for assessing the reasons for chewing betel quid which contributes toward the goal of developing effective interventions to reduce betel quid chewing in vulnerable populations.

Methods

The current study assessed the factor structure, reliability and convergent validity of the Reasons for Betel-quid Chewing Scale (RBCS), a newly developed 10 item measure adapted from several existing “reasons for smoking” scales. The measure was administered to 351 adult betel-quid chewers in Guam.

Results

Confirmatory factor analysis of this measure revealed a three factor structure: reinforcement, social/cultural, and stimulation. Further tests revealed strong support for the internal consistency and convergent validity of this three factor measure.

Conclusion

The goal of designing an intervention to reduce betel-quid chewing necessitates an understanding of why chewers chew; the current study makes considerable contributions towards that objective.
Literature
1.
go back to reference Gupta PC, Warnakulasuriya S: Global epidemiology of areca nut usage. Addict Biol. 2002, 7 (1): 77-83. 10.1080/13556210020091437.CrossRefPubMed Gupta PC, Warnakulasuriya S: Global epidemiology of areca nut usage. Addict Biol. 2002, 7 (1): 77-83. 10.1080/13556210020091437.CrossRefPubMed
2.
go back to reference Boucher BJ, Mannan N: Metabolic effects of the consumption of Areca catechu. Addict Biol. 2002, 7 (1): 103-110. 10.1080/13556210120091464.CrossRefPubMed Boucher BJ, Mannan N: Metabolic effects of the consumption of Areca catechu. Addict Biol. 2002, 7 (1): 103-110. 10.1080/13556210120091464.CrossRefPubMed
3.
go back to reference Warnakulasuriya S, Peters TJ: Introduction: Biology, medical and socio-economic aspects of areca nut use. Addict Biol. 2002, 7: 75-76. 10.1080/13556210020091428.CrossRef Warnakulasuriya S, Peters TJ: Introduction: Biology, medical and socio-economic aspects of areca nut use. Addict Biol. 2002, 7: 75-76. 10.1080/13556210020091428.CrossRef
4.
go back to reference Winstock A: Areca nut-abuse liability, dependence and public health. Addict Biol. 2002, 7 (1): 133-138. 10.1080/13556210120091509.CrossRefPubMed Winstock A: Areca nut-abuse liability, dependence and public health. Addict Biol. 2002, 7 (1): 133-138. 10.1080/13556210120091509.CrossRefPubMed
5.
go back to reference World Health Organization: WHO Global Report on Mortality Attributable to Tobacco. 2012, Virginia: Stylus Publishing LLC World Health Organization: WHO Global Report on Mortality Attributable to Tobacco. 2012, Virginia: Stylus Publishing LLC
6.
go back to reference IARC Working Group on the Evaluation of Carcinogenic Risks to Humans: IARC monographs on the evaluation of carcinogenic risks to humans. Betel-quid and areca-nut chewing and some areca-nut derived nitrosamines. 2004, Lyon, France: IARC, 85. 08: 1-334. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans: IARC monographs on the evaluation of carcinogenic risks to humans. Betel-quid and areca-nut chewing and some areca-nut derived nitrosamines. 2004, Lyon, France: IARC, 85. 08: 1-334.
7.
go back to reference Trivedy CR, Craig G, Warnakulasuriya S: The oral health consequences of chewing areca nut. Addict Biol. 2002, 7 (1): 115-125. 10.1080/13556210120091482.CrossRefPubMed Trivedy CR, Craig G, Warnakulasuriya S: The oral health consequences of chewing areca nut. Addict Biol. 2002, 7 (1): 115-125. 10.1080/13556210120091482.CrossRefPubMed
8.
go back to reference Lin CF, Wang JD, Chen PH, Chang SJ, Yang YH, Ko YC: Predictors of betel quid chewing behavior and cessation patterns in Taiwan aborigines. BMC Public Health. 2006, 6: 271-277. 10.1186/1471-2458-6-271.CrossRefPubMedPubMedCentral Lin CF, Wang JD, Chen PH, Chang SJ, Yang YH, Ko YC: Predictors of betel quid chewing behavior and cessation patterns in Taiwan aborigines. BMC Public Health. 2006, 6: 271-277. 10.1186/1471-2458-6-271.CrossRefPubMedPubMedCentral
9.
go back to reference Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, Gupta PC, Handa Y, Abdullah N, Zain RB: Factors affecting commencement and cessation of betel quid chewing behaviour in Malaysian adults. BMC Public Health. 2011, 11: 82-87. 10.1186/1471-2458-11-82.CrossRefPubMedPubMedCentral Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, Gupta PC, Handa Y, Abdullah N, Zain RB: Factors affecting commencement and cessation of betel quid chewing behaviour in Malaysian adults. BMC Public Health. 2011, 11: 82-87. 10.1186/1471-2458-11-82.CrossRefPubMedPubMedCentral
10.
go back to reference Lee CH, Ko AM, Warnakulasuriya S, Ling TY, Sunarjo PS, Rajapakse RB, Zain SO, Ibrahim SS, Zhang HJ, Wu L, Liu B, Kuntoro SA, Utomo IA, Warusavithana N, Razak P, Abdullah TY, Shrestha CF, Shieh YC, Yen YC, Ko YC: Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: an Asian Betel-quid Consortium Study. Am J Public Health. 2012, 102 (3): e17-e24. 10.2105/AJPH.2011.300521.CrossRefPubMedPubMedCentral Lee CH, Ko AM, Warnakulasuriya S, Ling TY, Sunarjo PS, Rajapakse RB, Zain SO, Ibrahim SS, Zhang HJ, Wu L, Liu B, Kuntoro SA, Utomo IA, Warusavithana N, Razak P, Abdullah TY, Shrestha CF, Shieh YC, Yen YC, Ko YC: Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: an Asian Betel-quid Consortium Study. Am J Public Health. 2012, 102 (3): e17-e24. 10.2105/AJPH.2011.300521.CrossRefPubMedPubMedCentral
11.
go back to reference Abrams DB, Niaura RS: Social learning theory. Psychological theories of drinking and alcoholism. Edited by: Blane HT, Leonard KE. 1987, New York: Guilford Press, 181-226. Abrams DB, Niaura RS: Social learning theory. Psychological theories of drinking and alcoholism. Edited by: Blane HT, Leonard KE. 1987, New York: Guilford Press, 181-226.
12.
go back to reference Brandon TH, Juliano LM, Copeland AL: Expectancies for tobacco smoking. How expectancies shape experience. Edited by: Kirsch I. 1999, Washington, DC: American Psychological Association, 263-299.CrossRef Brandon TH, Juliano LM, Copeland AL: Expectancies for tobacco smoking. How expectancies shape experience. Edited by: Kirsch I. 1999, Washington, DC: American Psychological Association, 263-299.CrossRef
13.
go back to reference Sussman SY, Ames SL: Drug abuse: concepts, prevention, and cessation. 2008, Cambridge: Cambridge University PressCrossRef Sussman SY, Ames SL: Drug abuse: concepts, prevention, and cessation. 2008, Cambridge: Cambridge University PressCrossRef
14.
go back to reference Kuo SC, Lew-Ting CY: The Health Lifestyles of Areca quid-chewing Taxi Drivers-An Exploratory Study from the Viewpoint of Social Context. Taiwan J Public Health. 2008, 27 (1): 67-80. Kuo SC, Lew-Ting CY: The Health Lifestyles of Areca quid-chewing Taxi Drivers-An Exploratory Study from the Viewpoint of Social Context. Taiwan J Public Health. 2008, 27 (1): 67-80.
15.
go back to reference Brandon TH, Baker TB: The Smoking Consequences Questionnaire: the subjective expected utility of smoking in college students. Psychol Assess. 1991, 3: 484-491.CrossRef Brandon TH, Baker TB: The Smoking Consequences Questionnaire: the subjective expected utility of smoking in college students. Psychol Assess. 1991, 3: 484-491.CrossRef
16.
go back to reference Berlin I, Singleton EG, Pedarriosse AM, Lancrenon S, Rames A, Aubin HJ, Niaura R: The Modified Reasons for Smoking Scale: factorial structure, gender effects and relationship with nicotine dependence and smoking cessation in French smokers. Addiction. 2003, 98 (11): 1575-1583. 10.1046/j.1360-0443.2003.00523.x.CrossRefPubMed Berlin I, Singleton EG, Pedarriosse AM, Lancrenon S, Rames A, Aubin HJ, Niaura R: The Modified Reasons for Smoking Scale: factorial structure, gender effects and relationship with nicotine dependence and smoking cessation in French smokers. Addiction. 2003, 98 (11): 1575-1583. 10.1046/j.1360-0443.2003.00523.x.CrossRefPubMed
17.
go back to reference Piper ME, Piasecki TM, Federman EB, Bolt DM, Smith SS, Fiore MC, Baker TB: A multiple motives approach to tobacco dependence: the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). J Consult Clin Psychol. 2004, 72: 139-154.CrossRefPubMed Piper ME, Piasecki TM, Federman EB, Bolt DM, Smith SS, Fiore MC, Baker TB: A multiple motives approach to tobacco dependence: the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). J Consult Clin Psychol. 2004, 72: 139-154.CrossRefPubMed
18.
go back to reference Winstock AR, Trivedy CR, Warnakulasriy KAAS, Peters TJ: A dependency syndrome related to areca nut use: Some medical and psychological aspects among areca nut users in the Gujarat community in the UK. Addict Biol. 2000, 5: 173-179. 10.1080/13556210050003766.CrossRefPubMed Winstock AR, Trivedy CR, Warnakulasriy KAAS, Peters TJ: A dependency syndrome related to areca nut use: Some medical and psychological aspects among areca nut users in the Gujarat community in the UK. Addict Biol. 2000, 5: 173-179. 10.1080/13556210050003766.CrossRefPubMed
19.
go back to reference Lee CY, Chang CS, Shieh TY, Chang YY: Development and validation of a self-rating scale for betel quid chewers based on a male-prisoner population in Taiwan: The Betel Quid Dependence Scale. Drug Alcohol Depend. 2012, 121 (1–2): 18-22.CrossRefPubMed Lee CY, Chang CS, Shieh TY, Chang YY: Development and validation of a self-rating scale for betel quid chewers based on a male-prisoner population in Taiwan: The Betel Quid Dependence Scale. Drug Alcohol Depend. 2012, 121 (1–2): 18-22.CrossRefPubMed
20.
go back to reference Herzog TA, Murphy KL, Little MA, Suguitan GS, Pohkrel P, Kawamoto CT: The Betel Quid Dependence Scale: Replication and extension in a Guamanian sample. Drug Alcohol Depend. 2014, 138: 154-160.CrossRefPubMedPubMedCentral Herzog TA, Murphy KL, Little MA, Suguitan GS, Pohkrel P, Kawamoto CT: The Betel Quid Dependence Scale: Replication and extension in a Guamanian sample. Drug Alcohol Depend. 2014, 138: 154-160.CrossRefPubMedPubMedCentral
21.
go back to reference Muthén LK, Muthén BO: Mplus: User’s Guide. 2010, Muthén & Muthén: Los Angeles, CA, 6 Muthén LK, Muthén BO: Mplus: User’s Guide. 2010, Muthén & Muthén: Los Angeles, CA, 6
22.
go back to reference Ho R: Handbook of Univariate and Multivariate Data Analysis and Interpretation with SPSS. 2006, New York: Chapman and Hall/VRV, Taylor & Francis GroupCrossRef Ho R: Handbook of Univariate and Multivariate Data Analysis and Interpretation with SPSS. 2006, New York: Chapman and Hall/VRV, Taylor & Francis GroupCrossRef
23.
go back to reference Bentler PM: On tests and indices for evaluating structural models. Pers Individ Dif. 2007, 42: 825-829. 10.1016/j.paid.2006.09.024.CrossRef Bentler PM: On tests and indices for evaluating structural models. Pers Individ Dif. 2007, 42: 825-829. 10.1016/j.paid.2006.09.024.CrossRef
24.
go back to reference Yu CY, Muthén B: Evaluation of model fit indices for latent variable models with categorical and continuous outcomes. 2002, New Orleans, LA: Paper presented at the annual meeting of the American Educational Research Association Yu CY, Muthén B: Evaluation of model fit indices for latent variable models with categorical and continuous outcomes. 2002, New Orleans, LA: Paper presented at the annual meeting of the American Educational Research Association
25.
go back to reference Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model. 1999, 6 (1): 1-55. 10.1080/10705519909540118.CrossRef Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model. 1999, 6 (1): 1-55. 10.1080/10705519909540118.CrossRef
26.
go back to reference Meredith W: Measurement invariance, factor analysis and factorial invariance. Psychometrika. 1993, 58 (4): 525-543. 10.1007/BF02294825.CrossRef Meredith W: Measurement invariance, factor analysis and factorial invariance. Psychometrika. 1993, 58 (4): 525-543. 10.1007/BF02294825.CrossRef
27.
go back to reference SAS Institute: The SAS System for Windows, Release 9.3. 2011, Cary: NC SAS Institute: The SAS System for Windows, Release 9.3. 2011, Cary: NC
28.
go back to reference Perkins KA, Conklin CA, Levine MD: Cognitive-behavioral therapy for smoking cessation: a practical guidebook to the most effective treatments. 2008, New York: Routledge Perkins KA, Conklin CA, Levine MD: Cognitive-behavioral therapy for smoking cessation: a practical guidebook to the most effective treatments. 2008, New York: Routledge
Metadata
Title
The reasons for betel-quid chewing scale: assessment of factor structure, reliability, and validity
Authors
Melissa A Little
Pallav Pokhrel
Kelle L Murphy
Crissy T Kawamoto
Gil S Suguitan
Thaddeus A Herzog
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2014
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/1472-6831-14-62

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