Betel Quid Chewing: Cultural Practices and Associated Factors Among the Orang Asli in Peninsular Malaysia

Abstract

Betel quid chewing is a traditional practice prevalent in many Asian countries, including among the Indigenous people (Orang Asli) in Malaysia. This habit poses serious health risks, such as oral cancer, diabetes, hypertension, cardiovascular disease, and adverse pregnancy outcomes. Despite these known health implications, there is limited data and targeted interventions addressing this culturally significant behavior among the marginalized Orang Asli population. This study examined the prevalence and sociodemographic and risk behavioral factors associated with betel quid chewing among Orang Asli communities in Peninsular Malaysia. Data of 10,787 respondents aged 13 years and above were extracted from the 2022 Orang Asli Health Survey (OAHS), a population-based cross-sectional study using stratified random sampling. Complex sample design analysis and multivariable logistic regression were applied. The prevalence of betel quid chewing was 45.5%. Significant factors associated with betel quid chewing included being female (adjusted odds ratio [aOR] = 1.58,95% CI [1.21, 2.06]), Proto-Malay tribe (aOR = 7.41,95% CI [3.87, 14.15]), married/living with a partner (aOR = 1.60,95% CI: [0.28, 2.01]), employed (aOR = 2.80,95% CI [1.35, 5.76]), housewife/homemaker (aOR = 2.87,95% CI [1.35, 6.11]), tobacco user (aOR = 2.22,95% CI [1.85, 2.66]), and alcohol drinker (aOR = 1.41,95% CI [1.08, 1.85]). These findings highlight the need for culturally tailored interventions and preventive strategies targeting high-risk subgroups, such as married women and the Proto-Malay tribe, to reduce betel quid use and its associated health consequences.