{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:29:13Z","timestamp":1786422553500,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Oral cancer is a major public health problem in India, with the highest number of cases and deaths in the world, and Betel Quid (BQ) chewing is responsible for almost 50% of cases. BQ Use Disorder (BUD) prevalence and severity have never been investigated among Indian BQ chewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 1281 adult routine BQ chewers attending five dental healthcare centers were interviewed using a pretested 11\u2010item BUD questionnaire based on the DSM\u20105 substance use disorder (SUD) diagnostic criteria. Demographic, lifestyle, and other BQ\u2010related variables also were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Females were almost 80%, and two\u2010thirds were rural residents. BQ was used prevalently with friends; the average initiation age was 24\u2009years, and two\u2010thirds used BQ daily. Severe and mild\u2010to\u2010moderate BUD was detected in 49% and 45% of individuals, respectively. The average BUD score (range 0\u201311) was 5.2. Sex\u2010standardized severe BUD prevalence was 54.9% (95% confidence interval, 49.8%\u201359.7%). Female sex, older age, being married, using BQ with friends, and adding tobacco were inversely associated with severe BUD. Multicollinearity was noted among these factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe BUD was highly prevalent in Indian BQ chewers. Intervention programs aimed at assisting chewers to quit the habit should account for this dramatic situation. Appropriate measures should be taken to effectively influence cessation rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70118","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:29:56Z","timestamp":1760164196000},"page":"1544-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severity of Betel Quid Use Disorders (\n                    <scp>BUD<\/scp>\n                    ) Among Adult Indian Betel Quid Chewers"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-8860","authenticated-orcid":false,"given":"Stefano","family":"Petti","sequence":"first","affiliation":[{"name":"Department of Public Health and Infectious Diseases Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7000-6609","authenticated-orcid":false,"given":"Roopa Shamsundar","family":"Rao","sequence":"additional","affiliation":[{"name":"Faculty of Dental Sciences Ramaiah University of Applied Sciences  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pallavi","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"H.K.E S's S. Nijalingappa Institute of Dental Sciences &amp; Research  Kalaburgi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6441-0426","authenticated-orcid":false,"given":"Sowmya Gujjar Vishnu","family":"Rao","sequence":"additional","affiliation":[{"name":"Institute of Dental Sciences Bareilly International University  Bareilly Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Lingappa","sequence":"additional","affiliation":[{"name":"Bapuji Dental College and Hospital  Davangere Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0080-129X","authenticated-orcid":false,"given":"Krishna Sireesha","family":"Sundaragiri","sequence":"additional","affiliation":[{"name":"RUHS College of Dental Sciences  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2867-4715","authenticated-orcid":false,"given":"Chandni","family":"Shekhawat","sequence":"additional","affiliation":[{"name":"RUHS College of Dental Sciences  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejavathi","family":"Nagaraj","sequence":"additional","affiliation":[{"name":"Sri Rajiv Gandhi College of Dental Sciences  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surendra","family":"Lakshminarayana","sequence":"additional","affiliation":[{"name":"Faculty of Dental Sciences Ramaiah University of Applied Sciences  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2103-0746","authenticated-orcid":false,"given":"Saman","family":"Warnakulasuriya","sequence":"additional","affiliation":[{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/1735\u20103327.111760"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2003.008466"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2022.101317"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/88.1.176"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28643"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/srmjrds.srmjrds_127_23"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000197389"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12060782"},{"key":"e_1_2_10_12_1","volume-title":"Oral Cancer Prevention","author":"IARC Working Group on the Evaluation of Cancer\u2010Preventive Interventions","year":"2023"},{"key":"e_1_2_10_13_1","first-page":"1","article-title":"Betel\u2010Quid and Areca\u2010Nut Chewing and Some Areca\u2010Nut Derived Nitrosamines","volume":"85","author":"IARC Working Group on the Evaluation of Carcinogenic Risks to Humans","year":"2004","journal-title":"IARC Monographs on the Evaluation of Carcinogenic Risks to Humans"},{"key":"e_1_2_10_14_1","unstructured":"International Agency for Research on Cancer (IARC).2022.\u201cCancer Today. 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