References
ORAL CANCER
CONSORT flow diagram for the Betel Nut Intervention Trial.Description of the intervention sessions for the Betel Nut Intervention Trial.Introduction to the program. Obtain signed, informed consent.Health risks of areca nut and betel quid (ANBQ) chewingIntroduce self-monitoring logsIntroduce ‘trigger’ logsDiscuss how to incrementally cut back on chewing prior to cessationSaliva collection and baseline surveyDiscuss trigger logs and self-managementDiscuss lifestyle changes that encourage ANBQ cessationPreparing “excuses” for not chewing and the use of ANBQ substitutesPrepare for the upcoming Quit Day (morning of the next session)QUIT DAYEncourage participants to be helpful and supportive to other participants regardless of chewing statusEmphasize to participants that withdrawal symptoms generally last for 2 weeks before abatingReinforce coping techniques to prevent relapseUtilize social support to maintain chewing abstinenceEmphasize alternative behaviors to chewing (e.g., physical activity)Review and discuss quitting experiences, including coping strategies and different methods that participants used to manage triggers and avoid high-risk situations. Emphasize the immediate benefits of ANBQ cessation on healthReview the negative health risks of ANBQ chewing, including the increased risk of oral cancer and other oral diseasesEmphasize additional strategies for managing urges to chew ANBQContinue to support maintenance of chewing abstinence for those who quitEncourage participants who relapsed to chewing to attempt cessation againTeach approaches for managing thoughts and feelings that can result in relapseReinforce lifestyle changes that are compatible with quitting ANBQReview the use of “excuses” for not chewing and employing “fake chew” and other ANBQ substitutesPlan for the future, and discuss how to maintain ANBQ abstinence over time.Saliva collection and administer (22-day) survey assessmentBaseline participant characteristics.