THE JOURNAL OF THE STOMATOLOGICAL SOCIETY,JAPAN

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Betel quid chewing behavior is culturally accepted and prevalent in Southeast Asia, especially in Myanmar. However, chewing betel quid can cause serious diseases, such as oral cancer. Favorable beliefs about betel quid chewing work to promote this behavior, whereas proper knowledge of the chewing-related health consequences may reduce it. However, health-related belief and knowledge is known to vary across socioeconomic status. This study aimed to clarify the association between belief and knowledge and socioeconomic status. A questionnaire survey was conducted from August to November 2017 in the Bago region of Myanmar. A total of 1,492 adult respondents (age range, 25-64 years) were asked whether he/she is a current chewer, questions about belief and knowledge, and conditions of wealth status (as a representative of socioeconomic status). Logistic regression analysis was performed with behavior as the dependent variable, and belief score, knowledge score, wealth status, and these interaction terms as the main independent variables. The results showed that the effect of belief on chewing behavior was significantly positive, especially among the rich and poor. The effect of knowledge was significantly negative in part of the middle class, and significantly positive in the rich and poor depending on the levels of beliefs and knowledge. This suggests that promoting proper knowledge is effective in reducing betel quid chewing behavior in some middle-class people, but affects some rich and poor people adversely, implying that health education programs should be founded on a good understanding of the target population, including socioeconomic status.

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