Evidence map›Paper›PMID 27044010›Full record

ArticlePloS one2016

The Role of Physical Activity in Harm Reduction among Betel Quid Chewers from a Prospective Cohort of 419,378 Individuals.

Feng En Lo, Po Jung Lu, Min Kuang Tsai, June Han Lee, Christopher Wen, Chi Pang Wen, Jackson Pui Man Wai, Chwen Keng Tsao, Po Huang Chiang, Shu Yu Lyu and 5 more

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Inverse Association Between Betel Quid Use and Diabetes in Rural Bangladesh.American journal of human biology : the official journal of the Human Biology Council · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 2 countries.

Feng En LoDepartment of Leisure and Recreation Management, Asia University, Taichung, Taiwan.
Po Jung LuInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Min Kuang TsaiInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
June Han LeeInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Christopher WenDepartment of Radiological Sciences, University of California at Irvine, Irvine, CA, United States of America.
Chi Pang WenInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Jackson Pui Man WaiInstitute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan.
Chwen Keng TsaoMJ Health Management Institution, Taipei, Taiwan.
Po Huang ChiangInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Shu Yu LyuDepartment of Public Health, Taipei Medical University, Taipei, Taiwan.
Ko Lu MaTaoyuan Innovation Institute of Technology, Taoyuan, Taiwan.
Ying-Chen ChiDepartment of Education & Research, Taipei City Hospital, Taipei, Taiwan.
Chu-Shiu LiDepartment of Risk Management and Insurance, National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan.
Chwen-Chi LiuDepartment of Risk Management and Insurance, Feng Chia University, Taichung, Taiwan.
Xifeng WuDepartment of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
National Health Research Institutes · TWNational Kaohsiung First University of Science and Technology · TWTaipei City Hospital · TWAsia University · TWFeng Chia University · TWTaipei Medical University · TWThe University of Texas MD Anderson Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the benefits of regular exercise in reducing harms associated with betel quid (BQ) chewing.

methodsThe study cohort, 419,378 individuals, participated in a medical screening program between 1994 and 2008, with 38,324 male and 1,495 female chewers, who consumed 5-15 quids of BQ a day. Physical activity of each individual, based on "MET-hour/week", was classified as "inactive" or "active", where activity started from a daily 15 minutes/day or more of brisk walking (≥3.75 MET-hour/week). Hazard ratios for mortality and remaining years in life expectancy were calculated.

resultsNearly one fifth (18.7%) of men, but only 0.7% of women were chewers. Chewers had a 10-fold increase in oral cancer risk; and a 2-3-fold increase in mortality from lung, esophagus and liver cancer, cardiovascular disease, and diabetes, with doubling of all-cause mortality. More than half of chewers were physically inactive (59%). Physical activity was beneficial for chewers, with a reduction of all-cause mortality by 19%. Inactive chewers had their lifespan shortened by 6.3 years, compared to non-chewers, but being active, chewers improved their health by gaining 2.5 years. The improvement, however, fell short of offsetting the harms from chewing.

conclusionsChewers had serious health consequences, but being physically active, chewers could mitigate some of these adverse effects, and extend life expectancy by 2.5 years and reduce mortality by one fifth. Encouraging exercise, in addition to quitting chewing, remains the best advice for 1.5 million chewers in Taiwan.

Indexed as

Diabetes MellitusMasticationMotor ActivityNeoplasmsAdultArecaFemaleHumansMaleMiddle AgedPiperProspective StudiesRisk-TakingTaiwan

Identifiers

PMID27044010
PMCPMC4820123
OpenAlexW2338121518

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.