Yvette C Paulino1, Reynolette Ettienne2, Rachel Novotny3, Lynne R Wilkens4, Moria Shomour5, Cecilia Sigrah6, Shelley D Remengesau7, Emihner L Johnson8, Julia M Alfred9, Daisy F Gilmatam10. 1. School of Nursing and Health Sciences, Room 103, University of Guam, Mangilao, GU 96923, United States. Electronic address: paulinoy@triton.uog.edu. 2. Department of Kinesiology, Health and Nutrition, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, United States. Electronic address: Reynolette.ettienne@utsa.edu. 3. College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI 96822, United States. Electronic address: novotnyr@hawaii.edu. 4. University of Hawai'i Cancer Center, 701 Ilalo St., Honolulu, HI 96817, United States. Electronic address: lynne@cc.hawaii.edu. 5. Chuuk State Division of Public Health, P.O. Box 400, Weno, Chuuk State 96942, Federated States of Micronesia. Electronic address: mshomour@gmail.com. 6. Comprehensive Cancer Control Program Department of Health Services, P.O. Box 127, Tofol, Kosrae, 96944, Federated States of Micronesia. Electronic address: CSigrah@fsmhealth.fm. 7. Palau Community College, Koror, 96940, Palau. Electronic address: sremengesau@gmail.com. 8. Island Food Community of Pohnpei, Pohnpei, 96941, Federated States of Micronesia. Electronic address: info@islandfood.org. 9. P.O. Box 686, Majuro, MH 96960, Marshall Islands. Electronic address: rmissasapt@gmail.com. 10. P.O. Box 393, Colonia Yap, 96943, Federated States of Micronesia. Electronic address: DGilmatam@fsmhealth.fm.
Abstract
BACKGROUND: Chewing areca (betel) nut has been deemed carcinogenic. The practice has become a public health concern in Micronesia. The Children's Healthy Living (CHL) Program included an areca (betel) nut questionnaire in a survey of household characteristics in the Freely Associated States (FAS). This paper describes areca (betel) nut chewing practices of adults and the health behaviors of their children. METHODS: A cross-section of 1200 children (2-8 year-olds) and their caregivers in Chuuk, Kosrae, Pohnpei, Republic of Palau, Republic of the Marshall Islands (RMI), and Yap were recruited. Socio-demographics, adult areca (betel) nut chewing practices, and other health behaviors of children and adults were assessed. Child anthropometric measurements were collected to estimate weight status. RESULTS: The FAS areca (betel) nut chewing prevalence was 42%, ranging from 3% (RMI) to 94% (Yap). Among chewers, 84% added tobacco, 97% added slaked lime, 85% added betel leaf, and 24% mixed the components with alcohol. Among FAS children, 95% practiced daily teeth-brushing and 53% visited the dentist annually. Compared to non-chewing households, areca (betel) nut chewing households were more likely to have very young children enrolled, more highly educated adults, and members that used tobacco and alcohol. CONCLUSION: The FAS areca (betel) nut chewing prevalence (42%) is above the world prevalence of 10-20%, with wide variability across the islands. The oral health findings in this study may inform future oral cancer prevention programs or policies. Regular monitoring of areca (betel) nut use is needed to measure the impact of such programs or policies.
BACKGROUND: Chewing areca (betel) nut has been deemed carcinogenic. The practice has become a public health concern in Micronesia. The Children's Healthy Living (CHL) Program included an areca (betel) nut questionnaire in a survey of household characteristics in the Freely Associated States (FAS). This paper describes areca (betel) nut chewing practices of adults and the health behaviors of their children. METHODS: A cross-section of 1200 children (2-8 year-olds) and their caregivers in Chuuk, Kosrae, Pohnpei, Republic of Palau, Republic of the Marshall Islands (RMI), and Yap were recruited. Socio-demographics, adult areca (betel) nut chewing practices, and other health behaviors of children and adults were assessed. Child anthropometric measurements were collected to estimate weight status. RESULTS: The FAS areca (betel) nut chewing prevalence was 42%, ranging from 3% (RMI) to 94% (Yap). Among chewers, 84% added tobacco, 97% added slaked lime, 85% added betel leaf, and 24% mixed the components with alcohol. Among FAS children, 95% practiced daily teeth-brushing and 53% visited the dentist annually. Compared to non-chewing households, areca (betel) nut chewing households were more likely to have very young children enrolled, more highly educated adults, and members that used tobacco and alcohol. CONCLUSION: The FAS areca (betel) nut chewing prevalence (42%) is above the world prevalence of 10-20%, with wide variability across the islands. The oral health findings in this study may inform future oral cancer prevention programs or policies. Regular monitoring of areca (betel) nut use is needed to measure the impact of such programs or policies.
Authors: Rachel Novotny; Marie K Fialkowski; Aufa'i Apulu Ropeti Areta; Andrea Bersamin; Kathryn Braun; Barbara DeBaryshe; Jonathan Deenik; Michael Dunn; James Hollyer; Jang Kim; Rachael T Leon Guerrero; Claudio R Nigg; Ron Takahashi; Lynne R Wilkens Journal: Hawaii J Med Public Health Date: 2013-11
Authors: Fenfang Li; Lynne R Wilkens; Rachel Novotny; Marie K Fialkowski; Yvette C Paulino; Randall Nelson; Andrea Bersamin; Ursula Martin; Jonathan Deenik; Carol J Boushey Journal: Am J Hum Biol Date: 2015-10-12 Impact factor: 1.937
Authors: Lynne R Wilken; Rachel Novotny; Marie K Fialkowski; Carol J Boushey; Claudio Nigg; Yvette Paulino; Rachael Leon Guerrero; Andrea Bersamin; Don Vargo; Jang Kim; Jonathan Deenik Journal: BMC Public Health Date: 2013-10-09 Impact factor: 3.295
Authors: Yvette C Paulino; Anthony Ada; John Dizon; Elisha-Rose J Benavente; Katherine Mary De Luna Campbell; Breinard Cristobal; Alexandria Daughtry; Lorenz Michael O Estabillo; Victoria Diana Cruz Flisco; Grazyna Badowski; Margaret Hattori-Uchima Journal: BMC Public Health Date: 2021-11-03 Impact factor: 4.135
Authors: Wayne Buente; Francis Dalisay; Pallav Pokhrel; Hanae Kurihara Kramer; Ian Pagano Journal: J Med Internet Res Date: 2020-07-09 Impact factor: 5.428