Factors Influencing Betel Quid Dependency in Rural Bangladesh: A Cross-Sectional Study

Background: Areca nut, the fourth most commonly used social drug and the main component of betel quid, is widely consumed, with over 600 million users, mainly in Southern Asia. This addictive substance is carcinogenic and poses serious health risks, with well-documented negative effects on oral health, including lesions and cancer. The objective of this study is to assess the level of dependency among Betel Quid users and to identify the key factors that significantly influence this dependency.Method: This cross-sectional study was conducted on 400 randomly selected samples from a purposefully chosen rural subdistrict of Bangladesh between January and June 2023. A structured questionnaire was used to collect data on sociodemographics, betel quid usage, reasons for chewing, quit attempts, and dependency. Data analysis was conducted using SPSS and Jamovi, employing confirmatory factor analysis, structural equation modeling, and binary logistic regression. Results were reported as adjusted odds ratios with 95% confidence intervals and p-values.Conclusion: Validating a culture-specific, shorter version of the BQDS offers an opportunity for large-scale surveys. By collecting data on betel quid dependence, we can enhance public health initiatives and raise awareness about its risks, promoting healthier practices in communities.