Cross-sectional Study on Prevalence of Betel Nut Chewing among the Youth of Meghalaya, North East Region of India: Development of Multifaceted Prevention Strategy

Abstract

Introduction: Betel (Areca) nut intake, one of the most common oral chewing habits in the world, has been linked to the development of oral cancer, with India having an alarming situation with the highest number of registered oral cancer cases in the world. Method: A cross-sectional analysis was done among the young population of Meghalaya in the North Eastern Region of India, where this habit is prevalent. A questionnaire for on-ground data collection was administered to a total of n = 315 participants of both sexes from institutions in and near Shillong, Meghalaya. The relationship of this habit with social structure, knowledge, attitude, and risk perception was done. Result: A high prevalence rate of 78.09% was found among the school and undergraduate students from Shillong urban and adjoining rural areas for betel nut (BN) chewing with a higher female to male BN chewing ratio. This habit usually starts at the school level and persists for life. Peer pressure, lack of awareness, habituated families, and strong cultural linkage encourage children and adolescents to start chewing BN at an age as early as of 10 years. Lack of adequate awareness programs highlighting the ill-effects of BN and associated masticatory substances adds to the problem. Conclusion: Strategic, structured region-specific multifaceted awareness programs highlighting the potential health risks from uncontrolled, habitual usage of Areca nut has been proposed to prevent initiation of this habit.