Lay perspectives of health education information: In-depth interviews with areca quid chewing taxi drivers

Objectives: This study examined areca quid chewing taxi drivers' perspectives of areca quid related health information. Methods: Accompanied by an ex-taxi driver, the author visited one taxi driver for each interview at drivers' rest areas or waiting lines in Taipei. The interview conversation focused on the health effects of the behavior and the driver's thoughts. Results: A total of 44 areca quid chewing taxi drivers were interviewed in-depth between January and August 2003. Most taxi drivers received areca quid related health information from a variety of channels. However, they had very broad view of areca quid information. Some drivers identified their health status, constitution or genes, participation in a healthy lifestyle, and oral hygiene practices in determining the health risk of areca quid chewing. Some drivers considered themselves areca quid experts, and suggested that the health risk of areca quid was from an "overdose" or chewing the "wrong" kind of areca quid. A few drivers believed areca quid health information to be trivial. They said the hazardous environment and their daily survival were far more important than the health risk of chewing areca quid. Conclusions: Areca quid chewing taxi drivers are not uneducated individuals who require more or better areca quid health information. They integrated areca quid information with their own personal health knowledge and their daily experience, reinterpreted areca quid information, and took action. In order to communicate with the public and to change health behavior, public health experts need to recognize the significance of lay knowledge.