Abstract A088: Perceived barriers for participating in areca (betel) nut cessation

Background: Areca (betel) nut is a known carcinogenic substance consumed by 11% of the population in Guam. To address this rising public health concern, a cessation program was piloted for chewers. Results of the pilot were used to inform the delivery of the Betel Nut Intervention Trial (ClinicalTrials.gov ID: NCT02942745). Despite the intent of the program to help individuals overcome a potentially harmful behavior, recruiting betel nut chewers is difficult. Therefore, the purpose of this study is to explore the perception of betel nut among chewers and nonchewers in Guam, and to identify the factors preventing a chewer from wanting to quit and from wanting to join the cessation program. Design: Individual and group discussions were facilitated, utilizing questions designed to elicit responses relevant to perception of betel nut. Questions were adjusted to accommodate both chewer and nonchewer participants. Recurrent themes were extracted from the interviews and categorized into reasons associated with quitting and with joining a cessation program. Results: Nine interviews were facilitated with 17 chewer and nonchewer residents in Guam, with mean age = 36.4 years (standard deviation = 12.4). Results yielded 5 general categories, aggregated by chewer and nonchewer responses. Subcategories were further extracted to determine barriers for quitting (e.g., addiction, sociocultural importance, betel nut is harmless), and barriers to joining a cessation program (e.g., time, transportation, hypocrisy). Conclusions: Factors associated with reasons not to quit chewing and not to participate in a cessation program are variable. Current findings highlight a lack of available information regarding the harmful effects of betel nut consumption (i.e., carcinogenicity). The social and cultural construct within Guam's community may be a highly contributing factor to the overall acceptability of betel nut consumption practices, and for the lack of expressed need to quit. In addition, the findings also suggest that a cessation program designed for betel nut chewers should be mobilized to accommodate a chewer's time and transportation restraints. Future considerations include the implementation of betel nut health outcomes into a youth curriculum, and the development of a cessation program both convenient to chewers and specific to young betel nut chewers. Citation Format: Patrick Francis P. Sotto, Ana Joy Mendez, Thaddeus A. Herzog, Casierra Cruz, Jade S.N. Chennaux, Chandra