檳榔成癮之相關因素及焦慮與幸福感之關聯性

背景：檳榔是全球排名第四的成癮性物質。儘管各項數據都明確指出檳榔對人體有害，嚼食檳榔人口還是占有一定的比例。檳榔嚼食者成癮性不明，影響是否成癮的因素亦未明確地探討。雖然檳榔具有令人愉悅等藥理性作用，但尚未有研究指出其成癮性與嚼食者之焦慮感、幸福感的關聯性。藉由本研究探討檳榔成癮相關之影響因素，及檳榔成癮與焦慮感及幸福感之關聯性，作為發展協助檳榔嚼食者逐漸改變嚼食習慣、促進生理及心理健康之策略參考。研究目的： 1.以DSM-IV及發展中的DSM-V兩種不同診斷標準來評估檳榔嚼食者之依賴、濫用及成癮的症狀。 2.探討嚼食檳榔成癮的相關影響因素。 3.探討嚼食檳榔成癮與焦慮感及幸福感之關係。材料與方法：本研究以高雄市區嚼食檳榔者為研究對象，使用等比例隨機抽樣(Probability Proportionate to Size Sampling，PPS)的方式選取收案行政區。以結構式問卷量表為研究工具，採面對面訪談方式收集資料。實際訪視349人，受訪人數為208人，扣除資料遺漏之問卷後，共計 205 份完整樣本，問卷受訪率59.9%。結果：發展中的DSM-V的診斷標準，比起DSM-IV的診斷標準多納入了渴求（craving），診斷出的檳榔相關成癮者（betel quid related disorder）較為完全。 205名研究對象平均年齡為42.95歲，檳榔成癮的人口學相關因素包含男性、平均年齡較高、教育程度為高中或中以下、已婚。檳榔成癮與嚼食白灰檳榔（aOR＝4.4）、多量嚼食（aOR＝1.1）、愈早開始嚼食（aOR＝0.9-0.91）、嚼食年限長（aOR＝1.07-1.1）有關。酒精成癮（aOR＝4.8-7.5）及香菸成癮（aOR＝2.6-4.6）程度越高，與檳榔依賴或重度成癮的相關性也愈高。檳榔成癮與焦慮感無統計上的顯著相關，但檳榔依賴疾患（aOR＝2.2）及重度成癮疾患（aOR＝3.2）的幸福感顯著得較低。結論：本研究指出檳榔成癮性與特定的人口學、嚼食檳榔特性有關。檳榔、香菸、酒精之成癮性有共伴性的關係。雖然成癮者的焦慮程度並未較高，但檳榔依賴疾患與重度成癮疾患的幸福感較低。

關鍵字

檳榔；成癮；物質濫用；焦慮感；幸福感

並列摘要

Background Betel quid is the fourth psychoactive substance in the world. Though many studies indicated that betel quid is harmful to health, the prevalence of betel quid is still high. The tolerance and addiction of betel quid was not so clear , so that we would like to know the factors affecting betel disorder and the relationship between anxiety and happiness in the present study. Furthermore, we suggest that chewers should change the habit of chewing betel quid to promote both physical and mental health. Purpose 1. DSM-IV and DSM-V diagnose criteria was used to assess the disorder of betel quid chewing. 2. The factors related to betel quid disorder were analyzed. 3. The association among anxious, happiness, and betel quid disorder were explored. Material and methods The total sample number is 205 and the response rate was 59.9%.We used Probability Proportionate to Size Sampling to select the sample of our study and focus on chewers in Kaohsiung City in Taiwan. The participants were interviewed , using a well structured questionnaire . Results The average age of our sample is 42.95 years old. The chewers who are betel disorder relating to male , older age , lower or moderate education ,and married. The high risky factors relating betel chewers are chewing betel quid with lime and leaf (aOR＝4.4) , chewing higher quantity of betel quids (aOR＝1.1) , chewing betel quid in earlier time (aOR＝0.9-0.91), chewing for longer period(aOR＝1.07-1.1). Chewers who addict to alcohol (aOR＝4.8-7.5)and cigarette (aOR＝2.6-4.6) are related to betel quid disorder. While anxious does not related to betel disorder . The scores on the BAI are low in the betel quid chewers. The scores on happiness of moderate betel disorders is higher than severe betel disorders does. Conclusions We found that betel disorder is related to specific demographic factors and chewing characteristics. Furthermore , there is commodity between betel quids, cigarettes , and alcohol disorder. Though the betel disorders do not have high anxiety , the happiness is lower in the sever betel disorders.

並列關鍵字

betel quid , disorder ； substance abuse ； anxious ； happiness

參考文獻

1.IARC: Betel-quid and Areca-nut Chewing and Some Areca-nut-derived Nitrosamines. Monographs on the Evaluation of Carcinogenic Risks to Humans 2004, 85.