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The European Journal of Health Economics
Published in: The European Journal of Health Economics 4/2013

01-08-2013 | Original Paper

The effect of stimulants and their combined use with cigarettes on mortality: the case of betel quid

Authors: Shao-Hsun Keng, Sheng-Jang Sheu

Published in: The European Journal of Health Economics | Issue 4/2013

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Abstract

Ten percent of the world’s population use betel quid, making betel quid the fourth most used substance in the world. In Taiwan, there are an estimated 1.5 million users and the majority of them are also smokers. The number of people who died from oral cancer rose more than five times over the period from 1987 to 2006. In this study, we employ propensity score matching and the Weibull hazard model with instrumental variables to examine the health effects of betel quid chewing, in particular the health effect of its combined use with cigarettes. We show that betel quid chewing and smoking have a significant negative effect on health, and that the 10-year death hazard for joint users of betel quid and cigarettes doubles that for abstainers. Moreover, betel quid chewing is as harmful to health as smoking. We also find that betel quid chewing and smoking significantly increase the odds of dying from oral and oesophagus cancers.
Appendix
Available only for authorised users
Footnotes
1
Good reviews of the health effect of betel quid chewing can be found in IARC [23], Wen et al. [40] and Yen et al. [45].
 
2
See [4, 6, 10, 11, 13, 18, 19, 26, 29].
 
3
Caliendo and Kopeinig [9] provide a good review of the PSM.
 
4
The table includes only those respondents who survived at least two surveys. We exclude 494 respondents who died before the 1993 survey.
 
5
The logit estimates are available upon request. Figures 2, 3, 4 have similar frequency distributions.
 
6
The results from caliper matching are similar.
 
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Metadata
Title
The effect of stimulants and their combined use with cigarettes on mortality: the case of betel quid
Authors
Shao-Hsun Keng
Sheng-Jang Sheu
Publication date
01-08-2013
Publisher
Springer-Verlag
Published in
The European Journal of Health Economics / Issue 4/2013
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-012-0415-6

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