1. Introduction
oral cancer, Cancer
CANCER, ORAL CANCER, ORAL SQUAMOUS CELL CARCINOMA
Background: Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials—NCT02942745) is the first known randomized trial designed for ANBQ chewers. Methods: We compared the intensive behavioral treatment intervention condition (IC) with the control condition (CC) in the BENIT and included a 5-stage early stopping rule. We report the primary analysis at stage 3. English-literate adults in Guam and Saipan who self-identified as ANBQ chewers with tobacco were enrolled between August 2016 and August 2020. IC participants (Areca nut (AN), the drupe fruit of the Areca palm (In 2004, compelling evidence suggested strong associations between AN chewing and an increased risk of developing oral cancer (particularly oral squamous cell carcinoma), leading to the classification of AN chewing both with and without tobacco as carcinogenic to humans by the International Agency for Research on Cancer [Despite the global prominence of AN and BQ (ANBQ) and the devastating health burdens associated with their use, ANBQ remains an understudied research topic and an unappreciated global public health issue [One largely overlooked topic within ANBQ research is randomized trials of ANBQ cessation directed specifically at chewers who are ready to make a serious attempt to quit. However, there have been a few recent studies relevant to this issue. Lee et al. [