The reasons for betel-quid chewing scale: assessment of factor structure, reliability, and validity

BMC Oral Health. 2014 Jun 3;14:62. doi: 10.1186/1472-6831-14-62.


Background: Despite the fact that betel-quid is one of the most commonly used psychoactive substances worldwide and a major risk-factor for head-and-neck cancer incidence and mortality globally, currently no standardized instrument is available to assess the reasons why individuals chew betel-quid. A measure to assess reasons for chewing betel-quid could help researchers and clinicians develop prevention and treatment strategies. In the current study, we sought to develop and evaluate a self-report instrument for assessing the reasons for chewing betel quid which contributes toward the goal of developing effective interventions to reduce betel quid chewing in vulnerable populations.

Methods: The current study assessed the factor structure, reliability and convergent validity of the Reasons for Betel-quid Chewing Scale (RBCS), a newly developed 10 item measure adapted from several existing "reasons for smoking" scales. The measure was administered to 351 adult betel-quid chewers in Guam.

Results: Confirmatory factor analysis of this measure revealed a three factor structure: reinforcement, social/cultural, and stimulation. Further tests revealed strong support for the internal consistency and convergent validity of this three factor measure.

Conclusion: The goal of designing an intervention to reduce betel-quid chewing necessitates an understanding of why chewers chew; the current study makes considerable contributions towards that objective.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Areca*
  • Attitude to Health*
  • Culture
  • Ethnic Groups
  • Female
  • Guam / ethnology
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Reinforcement, Psychology
  • Reproducibility of Results
  • Self Report*
  • Self Stimulation
  • Social Environment
  • Surveys and Questionnaires
  • Young Adult