Betel nut intervention trial study to be conducted in CNMI, Guam

University of Guam professor Dr. Yvette Paulino, PhD, fourth from left, sought the public’s cooperation and support for a betel nut intervention trial study that will be tested in the CNMI and Guam this year as part of a continuing study on the use of the betel nut and how to promote cessation. (Frauleine Villanueva-Dizon)

A betel nut intervention trial study will be tested in the CNMI and Guam this year as part of a continuing study on the use of the betel nut and how to promote cessation.

University of Guam professor Dr. Yvette Paulino, PhD sought the public’s cooperation and support for the study that they hope to conduct before summer

“This is the first time we’re doing this,” Paulino said. “Our intervention here will be modeling the tobacco intervention. So it’s a group-based cessation type of program so it’s a group-oriented approach to trying to quit.”

Paulino said meetings or sessions will occur over a period of five to six weeks and then follow-up sessions will be done after another six months. The study will run for three years.

Paulino said those who would want to be part of the intervention program must be at least 18 years old, however, participants will be chosen randomly if they will be under the full intervention or the partial, control program.

Over 300 participants will be sought from CNMI and Guam.

“It may be a challenge because people may not want to quit but I think the more they know about the effects of betel nut chewing especially those who want to quit chewing but don’t have the resource and maybe not know about it, we hope the community help us in spreading the awareness,” Paulino said.

The study aims to test the efficacy of the intensive group-based program among those who are willing to attempt to quit chewing and to quantitatively determine the efficacy of the group-based intervention trial using bio-verification.

A feasibility study on the betel nut cessation program was conducted in 2014 and was “well-received and yielded surprisingly high rates of self-reported betel nut cessation.”

Prior to this current study, Paulino completed a study conducted in 2010 to 2013 entitled “Development of protocols for studying oral precancerous lesions and other health risks among betel nut users in Micronesia.”

The study identified two classes of betel nut chewers based on seven betel nut behaviors, smoking and alcohol use.

Class 1 chewers are predominantly from Guam who chew mature, red betel nut. Most add leaf, few add lime and tobacco and most swallow. A 3.8 percent of them have been found to have oral predominantly malignant disorders.

Class 2 chewers, on the other hand, are predominantly those from Saipan who chew young betel nut both red and white. Most add lead, lime, and tobacco, but few swallow. They found that 19.4 percent had OPMD.

As those who chew betel nut on Saipan, according to her study, are class 2 chewers, they are significantly at risk of having OPMD than those in Guam.

Paulino said she decided to do the study as Micronesia is largely unrepresented in reports about betel nut behaviors.

Both studies were funded by the National Cancer Institute under the National Institutes of Health.

Paulino’s visit last Friday was part of the Commonwealth Cancer Association’s Oral Cancer Awareness program for this month.

For more information on the studies and those interested to take part may call the CCA office at 682-0050 or email at camarianas@gmail.com.