Areca quid chewing by Taiwanese adolescents: Application of the Attitudes Social Influence Self-efficacy (ASE) model

Aims: To investigate the factors associated with areca quid-chewing behaviour using the Attitudes-Social influence-Self-efficacy (ASE) model as a theoretical framework. Design: Cross-sectional survey. Setting and participants: A total of 400 students from a junior high school participated in the study in 2001 in Chia-Yi city (Taiwan). Measurements: Expectancy scales (for the attitude component of the ASE), a self-efficacy scale (for the self-efficacy component of the ASE) and a social norm scale (for the social influence component of the ASE) were utilized. These measures displayed good reliability and validity. Findings: Forty-seven students (11.75%) reported that they had tried chewing areca quid previously, eight of them practicing chewing it every day. Positive and negative expectancy (r = 0.43, r = 0.20), self- efficacy (r = -0.65), and subject social norm (r = 0.53) were significantly correlated with participants' intentions to chew areca quid. In a regression model, self-efficacy (β = -0.46, P < 0.001), social norm (β = 0.22, P < 0.001), positive expectancy (β = 0.18, P < 0.001) and negative expectancy (β = -0.08, P = 0.040) all made independent contributions to predicting intentions to chew and explained 46.8% of the variance in areca quid-chewing behaviour. Conclusions: Areca quid chewing appeared to be linked to positive expectancy and social norms pertaining to areca quid chewing associated with adolescents. However, high negative expectancy and high self-efficacy encouraged contrary behaviour. The application of the ASE model as the scenario could improve our understanding of the intention of the areca quid chewing among these adolescents.