Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

doi:10.3390/jpm11100973

. 2021 Sep 28;11(10):973.

doi: 10.3390/jpm11100973.

Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

Chao-Hsin Huang¹, Jiun-Hung Geng^{2

3}, Da-Wei Wu^{4

5}, Szu-Chia Chen^{4

6

7

8}, Chih-Hsing Hung^{8

9

10}, Chao-Hung Kuo^{4

7

11}

Affiliations

¹ Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
² Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
³ Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁴ Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Road, Hsiao-Kang District, Kaohsiung 812, Taiwan.
⁵ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁶ Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁷ Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁸ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁹ Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹⁰ Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
¹¹ Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

PMID: 34683114
PMCID: PMC8537851
DOI: 10.3390/jpm11100973

Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

Chao-Hsin Huang et al. J Pers Med. 2021.

. 2021 Sep 28;11(10):973.

doi: 10.3390/jpm11100973.

Authors

Chao-Hsin Huang¹, Jiun-Hung Geng^{2

3}, Da-Wei Wu^{4

5}, Szu-Chia Chen^{4

6

7

8}, Chih-Hsing Hung^{8

9

10}, Chao-Hung Kuo^{4

7

11}

Affiliations

¹ Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
² Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
³ Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁴ Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Road, Hsiao-Kang District, Kaohsiung 812, Taiwan.
⁵ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁶ Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁷ Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁸ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁹ Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
¹⁰ Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.
¹¹ Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

PMID: 34683114
PMCID: PMC8537851
DOI: 10.3390/jpm11100973

Abstract

The prevalence of betel nut chewing in Taiwan is high at approximately 7%, however, few studies have evaluated the relationship between betel nut chewing and lung disease. Therefore, the aim of this study was to investigate associations between betel nut chewing and lung function in 80,877 participants in the Taiwan Biobank (TWB). We further investigated correlations between betel nut chewing characteristics such as years of use, frequency, daily amount, and accumulative dose, with obstructive lung disease. We used data from the TWB. Lung function was assessed using spirometry measurements of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The participants were classified into normal lung function and obstructive lung function (FEV1/FVC < 70%) groups. The participants were asked questions about betel nut chewing, including years of use, frequency, and daily amount. After multivariable analysis, betel nut chewing (odds ratio [OR] = 1.159; p < 0.001) was significantly associated with FEV1/FVC < 70% in all participants (n = 80,877). Further, in the participants who chewed betel nut (n = 5135), a long duration of betel nut chewing (per 1 year; OR = 1.008; p = 0.012), betel nut use every day (vs. 1-3 days/month; OR = 1.793; p = 0.036), 10-20 quids a day (vs. <10 quids; OR = 1.404; p = 0.019), 21-30 quids a day (vs. <10 quids; OR = 1.662; p = 0.010), ≥31 quids a day (vs. <10 quids; OR = 1.717; p = 0.003), and high cumulative dose (per 1 year × frequency × daily score; OR = 1.001; p = 0.002) were significantly associated with FEV1/FVC < 70%. In this large population-based cohort study, chewing betel nut was associated with obstructive lung disease. Furthermore, a long duration of betel nut chewing, more frequent use, higher daily amount, and high cumulative dose were associated with obstructive lung disease. This suggests that preventing betel nut chewing should be considered to reduce obstructive lung disease in Taiwan.

Keywords: Taiwan biobank; betel nut chewing; cumulative dose; obstructive lung disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Flowchart of study population.

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[1] Labaki W.W., Han M.K. Chronic respiratory diseases: A global view. Lancet Respir. Med. 2020;8:531–533. doi: 10.1016/S2213-2600(20)30157-0. - DOI - PMC - PubMed

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[4] MacNee W. Pathology, pathogenesis, and pathophysiology. BMJ. 2006;332:1202–1204. doi: 10.1136/bmj.332.7551.1202. - DOI

[5] Decramer M., Janssens W. Chronic obstructive pulmonary disease and comorbidities. Lancet Respir. Med. 2013;1:73–83. doi: 10.1016/S2213-2600(12)70060-7. - DOI - PubMed

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[8] Volgin A.D., Bashirzade A., Amstislavskaya T.G., Yakovlev O.A., Demin K.A., Ho Y.J., Wang D., Shevyrin V.A., Yan D., Tang Z., et al. DARK Classics in Chemical Neuroscience: Arecoline. ACS Chem. Neurosci. 2019;10:2176–2185. doi: 10.1021/acschemneuro.8b00711. - DOI - PubMed

[9] Chu N.-S. Effects of betel chewing on the central and autonomic nervous systems. J. Biomed. Sci. 2001;8:229–236. doi: 10.1007/BF02256596. - DOI - PubMed

[10] Chu N.-S. Effects of betel chewing on the central and autonomic nervous systems. J. Biomed. Sci. 2001;8:229–236. doi: 10.1007/BF02256596. - DOI - PubMed

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Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

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Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

Authors

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Abstract

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Abstract

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