A cross-sectional study on the knowledge, attitudes and practice of chewing areca nut and its risk factors among college students.

Chewing areca nut is common in many nations. However, chewing areca nut may do more harm than good. We aimed to figure out the knowledge, attitudes, and practices of areca nut chewing among college students. An online cross-sectional survey was conducted among students at Central South University in Changsha in March 2023. The questionnaire included three parts: general characteristics, knowledge and attitudes toward areca nut chewing, usage and addiction to areca nut. Chi-square analysis was employed to compare the basic statistics and other characteristics of the areca nut chewing group and the non-chewing group. Binary logistic regression analysis was conducted to examine the effect of students' basic statistical information on areca nut chewing. Our study included 1417 participants in total. The mean age of the group was 21.35 years (SD = 1.62), which included 715 males (50.5%) and 702 females (49.5%). According to the survey, 317 students (22.4%) chewed areca nut as a habit; including 37.9% males and 6.6% females (p < 0.05). The results of binary logistic regression analysis showed a negative correlation between higher academic year and having siblings with the likelihood of a student using areca nut, while increasing age, male sex and having higher educational level of parents were positively associated with areca nut chewing. Of the participants, 57.6% thought there was no benefit from chewing areca nuts. 73.7% acquired knowledge about areca nut's health effects through TV or the internet. Gender, academic year, parental education level, and not being an only child may affect the habit of areca nut chewing among college students. The binary logistic regression analysis in this study found that gender, academic year, parental education level, and not being an only child may affect the habit of areca nut chewing among college students. Among all participants, the majority of students believed that areca nut had addictive substances and carcinogenicity, and most of them agreed that oral cancer can be prevented.