The Use of Endemic Pinang Fruit As a Media For Science Learning at Muhammadiyah Primary School Lab School Unimuda Sorong

Betel (areca) nut is an addictive psychoactive substance considered to be carcinogenic. Yet not much is known about factors that may be promoting betel nut use. To fill this void, the present study examines the roles of exposure to betel nut-related posts on social media and peer norms regarding betel nut use in explaining betel nut susceptibility and use among adolescents. We conducted a representative survey of early adolescents (N = 673) attending all public middle schools on Guam, a United States-Affiliated Pacific Island in the Western Pacific. Results showed that exposure to betel nut-related posts on social media was positively associated with peer descriptive norms regarding betel nut use. Specifically, the more frequent early adolescents were exposed to betel nut posts on social media, the more likely they were to perceive betel nut use to be more prevalent among their general peers and close friends. Additionally, early adolescents’ exposure to betel nut-related posts on social media was positively associated with both their susceptibility to use betel nut and reported use. Descriptive norms regarding close friends’ betel nut use was also positively associated with both susceptibility to and use of betel nut. However, descriptive norms regarding general peers’ betel nut use was unrelated with either betel nut susceptibility or use. Descriptive norms regarding close friends’ betel nut use mediated the relationships that exposure to betel nut posts on social media had with both betel nut susceptibility and betel nut use. Implications are discussed.

Eight manuscripts have specifically examined the effects of areca (betel) nut use in pregnant women, seven of which have documented adverse effects on birth weight, newborn neurological status, gender ratio and pregnancy outcomes such as anaemia and miscarriage following areca nut use during pregnancy. A retrospective cohort analysis of migrant and refugee pregnant women attending antenatal clinics along the Thai–Myanmar border (July 1997 to November 2006) was conducted to examine the adverse effects of areca nut use routinely recorded on enrolment. Of 7685 women, 2284 (29.7%) never used areca or smoked (cheroots), 2484 (32.3%) only used areca, 438 (5.7%) only smoked cheroots and 2479 (32.3%) used both areca and cheroots. Pieces of ripe areca nut in a leaf with lime, without tobacco, were used particularly among older multigravid women. Adverse pregnancy effects were not observed in areca nut users compared with non-users. Smoking, but not areca nut use, had a dose-related effect on miscarriage. Areca nut use in conjunction with smoking reduced the adverse effects of smoking on birth weight, further supporting a lack of effect of areca nut. Areca (betel) nut-related adverse pregnancy outcomes were not observed in this population, whereas smoking was clearly harmful. Differences from previous reports may result from the amount or types of areca nut, or quid content, consumed between countries. Smoking, but not areca nut, reduction is likely to improve pregnancy outcomes on the Thai–Myanmar border.

Background: Betel (areca) nut is an addictive substance chewed with or without tobacco widely in Asia and the Pacific, including the U.S.-affiliated Pacific Islands (USPI). Betel nut use has been found to cause oral cancer. Research suggests that most betel nut use initiation occurs in adolescence. However, very little is currently known about the etiology of adolescent betel nut use. The present study reports findings of a formative, qualitative research conducted to understand the attitudinal and social factors associated with adolescent betel nut use in USAPI. The objective was to develop a theoretical framework of adolescent betel nut etiology that would guide the development of a prevention program.Method: Semi-structured interviews were conducted with 20 adolescent betel nut users (M age = 14.5; SD = 2.2) from Guam.Results: Findings suggested a framework of adolescent betel nut etiology in which intrapersonal, social, and environmental factors influence betel nut use behavior.Conclusions: The framework is consistent with ecological frameworks of adolescent substance use in which proximal personal and social influences on adolescent substance use occur within the context of a wider socio-cultural context conducive to adolescent substance use. Specifically, we found that beliefs such as betel nut tastes good and induces relaxation represent some of the betel nut use motives; parental permissiveness and peer and sibling use encourage betel nut use; and cultural acceptance and easy accessibility to betel nuts provide an environmental context conducive to betel nut use. Findings are discussed in the context of developing an adolescent betel nut use prevention program.

Areca catechu L. is a type of palm whose direct use is still limited to certain consumers. This plant is rich in benefits. The use of areca nut is different from one area to another. This study deserves to be researched, as information for the Indonesian people about the use of areca nut. This study aims to identify betel nut species and to assess the use of betel nuts by the people of North Maluku. This research was a qualitative research. This research was conducted in 3 locations, namely 1 location in Jailolo Selatan sub-district to be precise in Sukadamai Village, West Halmahera Regency and 2 locations in Tidore Islands, precisely in Gurabunga Village and Rum Village. This research was conducted in June-July 2019. The data collection technique was done by means of observation, interviews, and documentation. The data that has been collected is then analyzed using a plant identification book and matching it with several references from research journals, while for interviews used data reduction techniques, data display, drawing conclusions and verification. Based on the research results, there are 5 species of areca nut, namely the common areca nut, the pare areca nut, the round areca nut, the areca nut, and the areca palm. As for the use of areca nut by the people of North Maluku, namely as an ingredient for daily consumption (chewing) with lime and betel, itching medicine, appetite enhancer for children and adults, eye purifier, cleaning the tongue in toddlers, overcoming discomfort in children. mouths of adults, anti migraine, traditional events (weddings, ceremonies for inviting genies), medicine for people with liver disease, and washing wounds.

Background : While there are known high rates of tobacco and betel (areca) nut use in the U.S.-Affiliated Pacific Islands (USAPI), there have been limited efforts at preventing the initiation of tobacco and betel nut among those living in the region, particularly, adolescents. To meet this need, Fuetsan Manhoben (FM)—a culturally tailored, school-based tobacco and betel nut use prevention curriculum—was developed for adolescents in Guam, a USAPI in the Western Pacific. Method : A pilot randomized controlled trial was conducted to examine the efficacy of FM. Guam public middle school students were randomly assigned to either the FM intervention (n = 269) or a control (n = 269) condition. Data were collected at baseline, posttest (4 weeks after baseline), and 3-month follow-up. Results : At posttest, FM had a statistically significant positive direct effect on risk perceptions of both cigarettes and betel nut. Also, risk perceptions of both cigarettes and betel nut measured at posttest inversely predicted intent to use cigarettes and betel nut at follow-up. FM also had an indirect effect on reducing intent to use betel nut at follow-up through its immediate and prior effect on betel nut use risk perceptions at posttest. Conclusions : The results provide initial support for the efficacy and feasibility of FM.

The eating of betel nuts has been a part of southern society for a long time, and it also appears in southern local literature. This article aims to analyze the role of “betel nuts” in southern local literature. The results of the study found five roles of betel nuts: 1. The use of betel nuts to express love and courtship among young men and women; 2. The use of kinship and the creation of social networks; 3. The use in various rituals, such as witchcraft, weddings, and life traditions; and 4. The use of betel nuts to express financial wealth; and 5. The use of idioms to teach or warn people. The eating and use of betel nuts mostly appear in local literature written before 1977. Currently, young people, even the elderly, do not like to eat betel nuts very much, but they still use them in various rituals, perhaps because betel nuts still play a role in the local way of life. Highlights This study helps to understand the connection between betel nut and the local literature of southern Thailand This study reveals the diverse roles of betel nut in the lives of local people in the southern region. This study helps to understand the contemporary people's perspectives on betel nut, which have changed according to the contextual conditions.

As adolescent tobacco use has been found to be a major predictor of future use, preventive efforts need to be focused on this section of population. To assess the role of knowledge regarding tobacco, risk-taking attitude, peers, and other influencers on tobacco and areca nut use, amongst adolescents. A school-based cross-sectional study covering two schools. Students of classes IX and XI, of selected schools, participated in the study (n = 596). A pretested and validated, close ended, self-administered questionnaire was used. Sociodemographic factors, awareness regarding tobacco, risk-taking attitudes, role of peers and other influencers, and tobacco, areca nut and alcohol use, were studied. Point estimates, 98% Confidence Intervals, tests of significance, bivariate and multivariate analysis (multiple logistic regression). Almost 42% of tobacco users started before the age of 12 years. Peer pressure, general stress, and media were important influencers. Logistic regression analysis showed that students in public school were using more tobacco [Odds ratio (OR) = 1.85, P = 0.174] and tobacco/areca nut (OR = 1.14, P = 0.02). The difference in use between the genders and class in which studying was statistically not significant. Lesser proportion of those possessing adequate knowledge regarding tobacco used it as compared to those without adequate knowledge (OR = 0.13, P < 0.001) however, possession of adequate knowledge was not a good predictor of areca nut consumption (OR = 0.86, P = 0.585). The most important correlate for tobacco use (OR = 6.41, P < 0.001) and areca nut use (OR = 11.17, P < 0.001) was risk-taking attitude. Multi-pronged and concerted efforts targeting children at an early age are required to prevent tobacco and areca nut use among adolescents.

Background： Adolescents from divorced families experience poorer mental health and lower self-esteem than those from intact families, and report more alcohol、tobacco and other drug use and antisocial behaviors. Lowered self-esteem，anxiety and depression may be motivations for substance abuse，particularly depressants. It is hoped that this research will give deeper insight into this area. Study objective： This study aims to explore the related factors affecting family structure, personality and peer effect on smoking, drinking and betel quid chewing in adolescent students. Methods： The study sample was taken from students of three junior high schools in Pingtung County in southern Taiwan. The total sample number was 1493 cases which included 462 seventh grade, 481 eighth grade、and 499 ninth grade students. The data of the research was collected by questionnaire. The researchers collected data via the new Lai personality examination, the Rosenberg Self-Esteem Scale（RSE）, the Center for Epidemiological Studies Depression Scale（CES-D）and also administered a structural questionnaire. The questionnaire contained basic demographic information on adolescent (include peer and family) attitudes and behavior toward smoking, drinking, and betel quid chewing . Results : The prevalent rate of betel quid chewing was 7.10% (male 11.97%, female 1.89%), cigarette smoking 14.09% (male 19.73%, female 8.12%), and alcohol drinking 21.60% (male 23.27%, female 19.83%) of interviewed students. Initial use was in the fifth-sixth grade. Logistic regression analysis showed the major factors influencing adolescent smoking, alcohol use, and betel nut use included: poor grades、family structure with grand-parenting、smoking, drinking and betel nut use attitude、peer and sibling behaviors、and overall academic achievement. Peer and sibling behavior had more relative importance than parenting influence on adolescent smoking and betel nut use. But family alcohol use more relative importance then peer. Lower self –esteem and externalized personality had some effect on smoking，alcohol use and betel-nut use, as did the influence of depression on smoking and drinking，but in logistic regression was not significant. Conclusion： The incidence of male smoking, alcohol use and betel nut use was higher then that for females, but in cigarette use the distinction between genders was reduced; with alcohol use there was no variation. Grand-parenting has an influence on adolescent smoking, alcohol and betel nut use more than in single parent and intact families, and focus should be placed on this problem. Peers and family will also influence these three behaviors, but peer smoking and betel nut use is more important than parental influences；family alcohol use is also more important than peer alcohol use. Externalized personality disassociation is linked with adolescent smoking，alcohol and betel-nut use. Intervention programs should be designed for early intervention and need to focus on adolescent personality、family structure、the teaching of mood relaxation techniques and the influence of peers in stopping smoking, drinking and betel quid chewing in adolescents.

Background: Betel nut use is a public health issue in the Asia-Pacific region that is often neglected. To control betel nut use, understanding of the adverse effects of betel nut use and evidence-based policies and strategies is necessary. Objectives: This narrative review aims to characterize the current situation on betel nut use at a global level regarding the epidemiology, pharmacology and toxicology, health effects, treatment options, policies and strategies. Methods: We found 139 existing literature published between 1970–2019 on the Web of Science database and other technical documents to collate the most relevant information on betel nut use. Data were categorized into appropriate themes. Results: The literature demonstrates that there is a lack of up to date statistics on betel nut use. There is limited research on the effect of policies and strategies to control betel nut use. Conclusion: Betel nut-chewing countries should focus on understanding which populations chew betel nut and implement appropriate policies, educational and cessation programs to help control betel nut use.

Comparative epidemiology of betel nut use versus ecstasy use among Taiwanese adolescents: Findings from a national survey

DesignA case–control study was carried out in Chennai, South India.Participant selectionAll subjects (cases and controls) were recruited from the outpatient department of Ragas Dental College and Hospital, Chennai. The cases were patients who had either reported for treatment of oral submucous fibrosis (OSF) or who had been diagnosed with OSF during routine oral examination. The clinical diagnosis was confirmed by biopsy in every case using established criteria. The control patients were chosen using a random selection method, in which every fifth patient of the outpatient department would be included. These individuals had no oral lesions other than periodontal disease associated with a chewing or smoking habit. One control was then selected for each case, matched by age (±2 years) and gender. All chewers in case and control groups used some form of areca nut at least once a day.Data analysisThe habits of cases and controls were classified into various categories without any overlap. Statistical tests were performed to find out if there was any significant difference in the duration, frequency and intensity of all habits between cases and controls. Univariate binary logistic regression was used to ascertain the significance of risk factors for the cases.ResultsA total of 185 consecutive patients with OSF were assigned corresponding age- and sex-matched controls. The male to female ratio of OSF cases was 9.9:1.0. All areca nut products were associated with OSF (Table 1), with the risk being greatest for pan masala (processed areca nut without betel leaf; odds ratio, 81.5). This was followed by areca nut plus alcohol use (odds ratio, 69.9). Smoking and alcohol, together or on their own, did not show any correlation with the occurrence of OSF but their concurrent use along with processed areca nut increased the risk of OSF (P<0.05). Both duration and intensity of habit showed a statistically significant difference between the cases and controls (P<0.002 and P<0.005, respectively). There was no significant difference in the frequency of chews per day between the cases and controls.Table 1 Areca nut habits and Odds ratiosFull size tableConclusionsThe present study confirms the strong association between areca nut use and OSF and between OSF and the increasing use of pan masala.

Background: Betel nut chewing is a public health concern in the Asia-Pacific region and is an emerging issue in Vanuatu. Despite the significant health risks associated with betel nut chewing, few interventions have been undertaken to reduce its harm. Objectives: To investigate betel nut use in Vanuatu and to identify opportunities to reduce its harm and possible interventions, framing the responses using the World Health Organization’s MPOWER tobacco control model. Method: Qualitative research design, in the form of semi-structured interviews with ten participants with expertise in health, agriculture, education or non-communicable disease in Port Vila, Vanuatu during June 2017. Recorded interviews were transcribed verbatim, and a general inductive approach was used to identify key themes. Results: Participants reported a recent increase in betel nut use in Vanuatu due to the influence from Papua New Guinea and the Solomon Islands. To reduce the harm of betel nut use in Vanuatu, participants suggested policies and strategies that aligned with the MPOWER framework that could be adopted for betel nut control, including restricting cultivation and sale of betel nut in Vanuatu and using radio and existing community networks to reach people with messages about the dangers of betel nut use. Conclusion: Betel nut use may be growing in popularity in Vanuatu, where there are potential policy options to minimize harm. The MPOWER model for tobacco control may be a useful framework to help the Vanuatu government to deliver a comprehensive approach to reducing harm from betel nut use.

Abstract: Adolescent substance use has been extensively studied in Western countries. However, knowledge of substance use, particularly betel nut use, among adolescents in the Pacific Islands, remains limited. The present study examined ethnic differences in betel nut use and intention to use, and factors explaining such ethnic differences, in Guam, a US-Affiliated Pacific Islands in the Western Pacific. Participants were 674 ethnically diverse students (49% female; Mage = 12.7, SD = 0.89) from eight local public middle schools. Self-report questionnaires were used to assess study variables. The results indicated that although the majority of participants did not use betel nut, there were significant differences in rates of betel nut use and intentions to use between ethnic groups. Compared with adolescents from other ethnic groups represented in the study, adolescents from the Freely Associated States (FAS) of Micronesia, or non-CHamoru Micronesians were more likely to use betel nut in the past 30 days and in their lifetime and to expect to use betel nut in the near future. These ethnic differences were partially mediated by proposed factors such as observation or familiarity with and access to betel nut and approval by parents, peers, and the community. In other words, FAS ethnicity was a significant predictor of higher levels of familiarity with betel nut; FAS ethnicity also predicted lower levels of difficulty in accessing betel nut and perceived disapproval of betel nut use from parents, peers, and the community. These, in turn, predicted more betel nut use and intention as reported by FAS adolescents. These findings can be used to inform the design and implementation of intervention and prevention programs to reduce ethnic disparities among at-risk youth vulnerable to betel nut use in the Pacific.

The present study examined the relationships between resistance to peer influence and cigarette and betel nut use, as well as the potential mediating role of friends who use cigarettes and betel nut, among boys and girls in Guam. This study included 673 ethnically diverse students (49% female; M age = 12.7, SD = 0.89) from eight public middle schools. The mediation analysis demonstrated that higher resistance to peer influence for both cigarette and betel nut use was associated with lower cigarette and betel nut use directly and that this association was mediated by friends who used cigarette and betel nut products. That is, low resistance to peer influence for both cigarette and betel nut use was associated with a greater number of friends who smoke and use betel nut, which was linked with more cigarette and betel nut use. The moderated mediation analysis revealed no gender difference in the indirect effect (i.e., the mediation of friends who used cigarettes and betel nut). These findings can be used to inform the design and implementation of intervention and prevention programs for at-risk youth, regardless of gender, who are vulnerable to substance use in the Pacific.

This study evaluated the effects of socio-economic variables and migration history on the prevalence of betel nut and smokeless tobacco use in both UK- and Bangladeshi born migrant women resident in London. No significant difference in betel nut use prevalence was found among women of different generations. However, in all groups betel nut users were significantly older and less educated than non-users. Among first generation women there was no effect of either length of time living in the UK or age at migration on use of betel nut, even after controlling for current age. No significant differences in prevalence use due to language spoken, occupation, marital status or borough of residence in London were found. We conclude that, although there are some indications of a change in behavior among younger individuals, betel nut chewing is a practice very much present among Bangladeshi women born and brought up in a bicultural context.