Taking actions to quit chewing betel nuts and starting a new life: taxi drivers’ successful experiences of quitting betel nut chewing

Aims and objectives: To understand taxi drivers’ successful experiences of quitting betel nut chewing. Background: Previous studies verified that betel nut chewing significantly increases the risk of oral cancer. In Taiwan, taxi drivers work for approximately 10–13 hours per day, and 31·7–80% of them choose to chew betel nuts for their invigorating qualities, which enable them to work more hours and receive more income. Design: A qualitative research design was used. Methods: This study used the grounded theory method with purposive sampling to perform in-depth interviews with male taxi drivers who had successfully quit betel nut chewing for more than six months. Results: The interviewed participants were 25 taxi drivers aged 45–67 who had chewed betel nuts for an average of 30·9 years. A constant comparative analysis of the 25 interviews revealed six categories, namely the first experience of chewing betel nuts, a part of work and life, perceiving the impact of betel nuts, trying to change, acting to quit betel nut chewing and starting a new life. Conclusions: During the cessation process, taxi drivers tended to be affected by their addiction to chewing betel nuts and the temptation of friends’ invitations to chew betel nuts. However, their recognition of the physical effects of betel nut chewing and their sense of responsibility and commitment to family were the critical factors affecting their determination to quit betel nut chewing. Their willpower to not to chew betel nuts and the source of their motivation to exercise self-control also contributed to their success. Relevance to clinical practice: Healthcare personnel should understand the experiences and perceptions of betel nut chewers, strengthen their understanding of the effects of betel nut chewing on physical health during the cessation period and support their self-efficacy and quitting behaviours with the assistance of significant others.