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Objective: In 2003 esophageal cancer was the sixth leading cause of death among men in Taiwan, but it is the fastest increasing (70%) alimentary tract cancer. The aim of this study was to investigate the impact of different habits of betel nut chewing on esophageal squamous cell carcinoma (SCC) and its interaction with cigarette use and alcohol consumption., Materials and Methods: All 165 cases were pathologically proven esophageal SCC patients (all male, mean age = 56.0, range = 35-92 years) diagnosed by biopsy during gastroendoscopic examinations. The control group comprised 255 subjects (all male, mean age = 54.8, range = 40-92 years) selected from patients who had visited the Otolaryngology Outpatient or Inpatient Department of KMUH owing to a benign lesion over this field. All were interviewed to collect demographic and substance use information by a trained interviewer using a standardized questionnaire., Results: Smoking (aOR = 5.4, 95% CI = 2.4-12.9, PAR = 72%), alcoholic beverage drinking (aOR = 17.6, 95% CI = 9.3-35.2, PAR = 76%) and low education level are independent risk factors for esophageal cancer. Although betel nut chewers only had a borderline significant higher risk than nonchewers (aOR = 1.7; 95% CI = 0.8-3.1), those who chewed with a piece of betel inflorescence (aOR = 4.2, 95% CI = 1.4-16.0) and swallow betel-quid juice (aOR = 3.3, 95% CI = 1.3-9.3) had a significant higher risk. Significant dose-response effects were found in daily quantity of drinking and smoking. There is a synergistic effect of these three substances on the development of esophageal cancer., Conclusion: Betel nut chewing plays a relevant role in the development of esophageal SCC but adds to the carcinogenetic effect of smoking and alcohol drinking. Direct mucosal contact of betel juice may contribute to its carcinogenesis.

This study explored the association between alienating job conditions and problem drinking within the context of occupational status and workplace drinking subculture. From December 1994 to March 1995, a questionnaire survey was implemented in the manufactory sector in southern Taiwan. Within the questionnaire, any perceived self-estrangement, powerlessness and social isolation that the individual experienced in his work were measured as the alienating job conditions, and any negative physical, psychological and social consequences the individual experienced during the previous month were considered as affecting problem drinking. Of the 1117 subjects, 668 (61.8%) reported imbibing one or more drinks during the preceding month; the average daily alcohol consumption being 0.2+/-0.9 drinks. In addition, 188 (16.8%) subjects reported having experienced drinking-related problems in the preceding month. Workers with low occupational status were more likely to become problem drinkers when they felt comparatively self-estranged in their work. Further, those with a family history including any habitual drinker or those under more encouraging workplace drinking subculture were more likely to have drinking-related problems. For the prevention of problem-related drinking behavior, the workplace should be considered as the focus of our future intervention and management program.

Deleterious health sequelae caused by licit and illicit substance use is a serious problem in our society. Adolescent students and particularly those who are prone to substance use are of special concern in the prevention of drug abuse. The purpose of this study was to investigate the prevalence of alcohol consumption, tobacco smoking and illicit drug use and to identify the risk factors related to these habits among adolescent students. A total of 1358 adolescent students aged 16-18 y old were recruited into this study via stratified random sampling from a vocational school in Kaohsiung city. Students were asked to complete a structured questionnaire anonymously and a 96.7% response rate was achieved. Prevalence of substances use was estimated as follows: alcohol drinking, 70.7% (boys 75.1%, girls 51.4%); tobacco smoking, 56% (boys 61.8%, girls 30.2%); illicit drug use 6.4% (boys 6.6%, girls 5.6%). Significant risk factors that emerged as common correlates with substances use were behaviour problems, non-negative attitude toward parent's substance use, and peer influence. A dose-response relationship was found between the prevalence of drinking, smoking, illicit drug use and the number of risk factors adolescents were exposed to. Prevention of adolescent substance abuse should be attempted and risk factors should be reduced. An educational approach is essential not only to gain/impart knowledge of substance abuse, but also to develop an effective program for health and social development.

The aim of this survey study was to explore the influence of work on individual's drinking behavior. From October 1994 to March 1995, the present researchers implemented a self-administered questionnaire survey on workers in the manufacturing sector in Metropolitan Kaohsiung area, southern Taiwan. Of the 1,117 subjects selected, 668 (61.8%) stated that they had had one or more drinks during the preceding month. The average daily consumption of alcohol was 0.2 +/- 0.9 drinks (with a range of 0 to 12 drinks and a median of 0.02 drinks). In addition, 188 (28.8%) of the subjects reported having experienced drinking-related problems during the preceding month, and 35 respondents (5.2%) gave escape from job stress as the reason for their drinking in the preceding month. The result of multivariate analyses showed that workers who reported less autonomy in their job were more likely to experience drinking-related problems (odds ratio [OR] = 1.3) and to drinking for psychological relief (OR = 1.2); that workers who reported more demanding job conditions were more likely to drink for escape (OR = 2.5) but had lower levels of drinking (t = -2.5, p = 0.01); and that workers who reported high levels of job strain were more likely to experience drinking-related problems and to drink for relief but had lower levels of drinking. The details and implications of this result will be discussed.

Alcohol use and betel quid chewing are common in aborigines in Taiwan. The aims of this study were to evaluate the patterns of drinking, smoking, betel quid chewing and to assess the related factors of the above substance use among female aborigines. Three hundred female Bunun aborigines aged between 17 and 50 years were recruited into this study via a stratified-random sampling. Subjects were interviewed at their homes by trained interviewers using a structured questionnaire. Prevalences of various substances use were estimated as follows: alcohol, 67.7%; betel quid chewing, 36.4%; smoking, 11.6%; and over-the-counter drugs, 8%. Related factors of substances use were analyzed by multiple logistic regression as follows. Alcohol use was significantly related to low educational level, where the spouse was a drinker and there was an attitude in favor of female drinking. Significant factors related to smoking were folk religion and where the spouse was a smoker. Significant factors related to betel chewing were low educational level, and where the spouse was a betel chewer, and poor knowledge about the adverse health effects of betel chewing. We also found women who consumed alcohol and chewed betel quid were significantly to show more external health locus control. About 80% of women recognized the adverse effects of alcohol consumption and smoking to pregnancy outcomes. Although they knew the harmful effects of substance use, only half of them stopped using these substances during their pregnancy. Health education on the harmful effects of alcohol, betel quid, and cigarettes, especially during pregnancy is essential in primary care.

The purposes of this study were: 1) to investigate the risk factors related to alcohol use among adolescents of fathers with alcoholism. 2) to compare their drinking behaviors with the adolescents whose fathers were non-alcoholics. Sixty-one adolescents, including 29 males and 32 females, aged from 12 to 22 whose fathers were alcoholics formed the case group. 122 age and sex matched adolescents in a ratio of 1:2 whose fathers were non-alcoholics were recruited as the comparison group (normal/control). Data were collected by interview during home visits or by mailing questionnaires to patients. The prevalence rates of drinking, smoking and betel-nut chewing among the adolescents of fathers with alcoholism were 67.2%, 19.7%, 18%. There was no significant difference in drinking behavior between the two groups. Beer was the most popular drink in adolescents' drinking habits. The most popular motivation of drinking was the peer pressure by friends. The significant risk factors of alcohol use among the adolescents included male poor mental health status adolescents with behavioral problems and alcohol use amongst classmates or friends.

Introduction: Alcohol consumption is a part of the aboriginal culture. It was found that is a predominant health problem in aboriginal community. There was little research describing whether gender differences in harmful drinking and adverse drinking consequence among aborigines. Thus, it is important to evaluate such differences in order to provide evidence for developing interventions in problem drinking. Aims: The aim of the study is to examine the gender differences in the prevalence, correlates, and adverse drinking consequences among harmful alcohol users in Taiwanese aborigines. Methods: A cross-sectional survey was conducted. 449 study participants, aged 18-60, were recruited into the study from community-dwelling aborigines in southern Taiwan. Alcohol Use Disorders Identification Test (AUDIT) was used to collect information regarding harmful alcohol drinking. Personal characteristics, related risk factors and adverse drinking consequences were assessed by questionnaire. Results: The result revealed that the prevalence of harmful drinking in male users was 71.6%, female users were 49.2%. The results showed that female harmful alcohol users were more likely to have poor mental health, 58% of them with suicidal ideation, 50% with depression, more inactive in religious practice, and unemployed. It was also found that more than half of the male harmful alcohol users have adverse drinking consequence, including accidental injury, quarreled with others, and unable to work. Conclusions: Harmful drinking was a predominant health problem in aborigines. This finding suggested that depression and suicidal ideation should be routinely evaluated for female harmful alcohol users by the professional of primary care. [Copyright &y& Elsevier]