Determinants of betel quid dependence and predictive efficacy of cessation scales among rural users in Southern India

Betel quid chewing poses significant public health risks across a range of countries from South to Southeast Asia, particularly in India. We aimed to identify factors influencing betel quid dependence (BQD) among consumers in a rural area of Southern India. A secondary aim was to find out which of the two instruments namely the Motivation to Stop Scale(MTSS), and Stages of Change Behavior scale was a better predictor of BQD among current betel quid users. 400 adult betel quid users were surveyed using the scales. We found that most of the participants were dependent on betel quid. BQD Scale scores increased with the participant's age and the frequency of daily betel quid chewing and decreased with increasing educational attainment, being in the precontemplation stage, and having better self-perceived oral health status. Significant associations were observed between sociodemographic, behavioral, or psychosocial factors and betel quid dependence and the 'Stages of Change' model emerged as a useful predictor of dependency levels, more so than the MTSS scale, indicating its potential application in tailoring cessation interventions.