Knowledge on Health Effects and Current Practice Toward Arecanut Use Among Secondary School Children Living in Malé City, Maldives

Abstract

Background: The fourth most commonly used addictive substance in the world is arecanut and is classified as a group 1 carcinogen to human. Over 600 million people are estimated to chew arecanut. It is consumed in some form or other, often with betel quid by 10%–20% of world's population. School goers lack the knowledge and practice toward arecanut use. Many high school children are not well aware about the health hazards of arecanut consumption. Most children start arecanut use at younger age. Arecanut consumption is more prevalent among boys than girls. Arecanut was introduced for majority of the school goers by either their friends or family. Most common form of arecanut used by school goers is sweetened supari. Aim: The current study was conducted to identify the knowledge on health effects, and current practice toward arecanut use among secondary school children living in Malé City, Maldives. Methods: A cross-sectional survey using precoded questionnaire was used. A total of 1350 questionnaire was distributed to the secondary school students studying at selected schools in Malé City and 804 questionnaires were returned. The total target population was 5297. The schools were selected through cluster sampling, while the students were selected via simple random sampling. The calculated sample size consists of 674 students which are equally selected from both genders. Data analyses were executed by using Excel and SPSS 21 software. Descriptive statistics and nonparametric tests were performed. Ethical approval was obtained from Villa College as well from national health research committee at ministry of health. Results: Secondary school children in Malé City have inadequate knowledge on harmful effects of arecanut use. The knowledge varies based on their gender, grade, school, and residence, but does not vary based on their age. The knowledge on harmful effects of arecanut use is more among girls, students at grade 9, students studying at Rehendhi school, and more among those who lives in both Hulhumalé and Vilimalé than those who live in Malé. The students started arecanut use mainly at age between 11-15 years. It was introduced by either friends or family members among large number of school children. Majority of participants used supari as a main form of arecanut, and Rasily supari was the favorite brand of supari among secondary school children. Boys start its use earlier, frequency, duration, and daily consumption is higher among boys than girls. Conclusion: Secondary school children have inadequate knowledge on harmful effects of arecanut use. Supari is the main form of arecanut use and most of the students initiated the habit at a younger age, which is an alarming threat to the society, hence there is an urgent need to start school based preventive programs, community awareness programs, for school children, teachers, parents, and general public at large as stopping the starting of a habit is much easier than quitting of same habit.