Department of Applied Economics, National University of Kaohsiung, 700 Kaohsiung University Rd., Kaohsiung 811, Taiwan.
Eur J Health Econ. 2013 Aug;14(4):677-95. doi: 10.1007/s10198-012-0415-6. Epub 2012 Aug 21.
Ten percent of the world's population use betel quid, making betel quid the fourth most used substance in the world. In Taiwan, there are an estimated 1.5 million users and the majority of them are also smokers. The number of people who died from oral cancer rose more than five times over the period from 1987 to 2006. In this study, we employ propensity score matching and the Weibull hazard model with instrumental variables to examine the health effects of betel quid chewing, in particular the health effect of its combined use with cigarettes. We show that betel quid chewing and smoking have a significant negative effect on health, and that the 10-year death hazard for joint users of betel quid and cigarettes doubles that for abstainers. Moreover, betel quid chewing is as harmful to health as smoking. We also find that betel quid chewing and smoking significantly increase the odds of dying from oral and oesophagus cancers.
全球有 10%的人口嚼食槟榔，使槟榔成为全球第四大最常使用的物质。在台湾，估计有 150 万人嚼食槟榔，其中大多数也是烟民。1987 年至 2006 年期间，死于口腔癌的人数增加了五倍多。在这项研究中，我们采用倾向得分匹配和带有工具变量的威布尔风险模型来研究嚼食槟榔的健康影响，特别是它与香烟同时使用的健康影响。我们表明，嚼食槟榔和吸烟对健康有显著的负面影响，而且同时嚼食槟榔和吸烟的人的 10 年死亡风险是不嚼食槟榔和不吸烟的人的两倍。此外，嚼食槟榔对健康的危害与吸烟相当。我们还发现，嚼食槟榔和吸烟会显著增加死于口腔癌和食道癌的几率。
