TY - JOUR
T1 - Residential Socioeconomic Environments and Areca Nut Use in Taiwan
T2 - A Comparison with Alcohol and Tobacco Use in Multilevel Analysis
AU - Lung, Yu
AU - Chang, Shu Sen
AU - Hsu, Chia Yueh
AU - Wu, Shang Chi
AU - Chen, Chuan Yu
AU - Chen, Wei J.
N1 - Funding Information:
We thank the collaborating researchers of the 2014 National Survey of Substance Use in Taiwan for their help in the design and implementation of the survey, including Wen-Ing Tsay, Yen-Tyng Chen, Po-Chang Hsiao, Ya-Hui Yu, Te-Tien Ting, Chuan-Yu Chen, Yu-Kang Tu, Jiun-Hau Huang, Hao-Jan Yang, Chung-Yi Li, Carol Strong, Cheng-Fang Yen, Chia-Feng Yen, and Jui Hsu. We thank Prof Yu-Kang Tu (Department of Epidemiology and Preventive Medicine, National Taiwan University) for his advice on statistical analysis. We also thank Ms. Chien-Yu Lin (Institute of Health Behaviors and Community Sciences, National Taiwan University) for producing the maps. Dr. Chia-Yueh Hsu was supported by grants from Wan Fang Hospital (107-wf-swf-05 and 109-wf-swf-04).
Publisher Copyright:
© 2020, © 2020 Taylor & Francis Group, LLC.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: While the association between residential socioeconomic environments and the use of globally common substances such as alcohol and tobacco has been well documented in Western countries, it remains little known about regionally important substances, such as areca nut in Asia. Objective: This study was aimed to develop residential environmental indicators in the context of Taiwan and examine their associations with areca nut use, in comparison to alcohol and tobacco use. Methods: Data were drawn from 13,392 adults across 168 townships in the 2014 National Survey on Substance Use in Taiwan. Residential socioeconomic environment variables were derived from the census and analyzed using factor analysis. Multilevel logistic regression models were used to examine the association of individual- and residential-level factors with the use of areca nut (use/nonuse), alcohol (harmful use, low-risk use, or nonuse), and tobacco (nicotine dependence, regular active use, or nonuse). Results: A three-factor structure of socioeconomic environments derived from 16 residential-level variables consisted of Rural Disadvantage, Affluence, and Family Fragmentation. Multilevel analyses showed that areca nut use was associated with both individual-level (male sex, age group 35-44 years, being divorced/widowed/separated, low educational attainment, and the occupational group of labors) and residential-level (Rural Disadvantaged and Family Fragmented) variables; such a profile was most similar to that of nicotine dependence. Conclusions: A three-factor structure could be derived for the residential-level socioeconomic environments in the Taiwanese context. Rural Disadvantaged and Family Fragmented were associated with areca nut use, which have implications for interventions targeted at the community level.
AB - Background: While the association between residential socioeconomic environments and the use of globally common substances such as alcohol and tobacco has been well documented in Western countries, it remains little known about regionally important substances, such as areca nut in Asia. Objective: This study was aimed to develop residential environmental indicators in the context of Taiwan and examine their associations with areca nut use, in comparison to alcohol and tobacco use. Methods: Data were drawn from 13,392 adults across 168 townships in the 2014 National Survey on Substance Use in Taiwan. Residential socioeconomic environment variables were derived from the census and analyzed using factor analysis. Multilevel logistic regression models were used to examine the association of individual- and residential-level factors with the use of areca nut (use/nonuse), alcohol (harmful use, low-risk use, or nonuse), and tobacco (nicotine dependence, regular active use, or nonuse). Results: A three-factor structure of socioeconomic environments derived from 16 residential-level variables consisted of Rural Disadvantage, Affluence, and Family Fragmentation. Multilevel analyses showed that areca nut use was associated with both individual-level (male sex, age group 35-44 years, being divorced/widowed/separated, low educational attainment, and the occupational group of labors) and residential-level (Rural Disadvantaged and Family Fragmented) variables; such a profile was most similar to that of nicotine dependence. Conclusions: A three-factor structure could be derived for the residential-level socioeconomic environments in the Taiwanese context. Rural Disadvantaged and Family Fragmented were associated with areca nut use, which have implications for interventions targeted at the community level.
KW - alcohol
KW - Areca nut
KW - multilevel analysis
KW - residential environments
KW - substance use
KW - tobacco
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U2 - 10.1080/10826084.2020.1788089
DO - 10.1080/10826084.2020.1788089
M3 - Article
C2 - 32654584
AN - SCOPUS:85087910952
SN - 1082-6084
VL - 55
SP - 2025
EP - 2034
JO - Substance Use and Misuse
JF - Substance Use and Misuse
IS - 12
ER -