嚼檳榔與成癮之關係近年來已被許多研究提出，特別是在生理機制或心理成癮方面，然而回顧國內有關嚼檳榔的研究多以探討口腔癌的致病因子或生理機制為多，本研究主要目的是探討嚼檳榔者主觀認為自己『成癮』時所呈現的行為特徵，並以此進一步發展嚼食檳榔依賴行為量表。
方法包括質性訪談及量表發展。質性訪談包括訪談24位嚼食檳榔者，以依賴為理論基礎，請受訪者從如何成為嚼食者的經驗談起，並擴展至生活影響。量表發展則以質性結果做為試題編製之依據。量表最初研擬27題，經訪談20位嚼食檳榔者後，進行詞語潤飾之修正，而後進行實地施測。施測時採立意取樣，樣本來源有三：一是產地嚼食者、二是一般嚼食者、三是因口腔相關疾病來醫院或診所就診者，本研究最後收集154份有效問卷。
結果如下：在深度訪談部分得知檳榔嚼食者主觀認為『成癮』的行為特徵，可歸成三類：戒斷症狀、失控、明顯影響。1）戒斷症狀包含口腔不適、生理影響，2）失控狀態包含持續嚼食、想的念頭、尋求檳榔、努力戒食，3）明顯影響則是對健康的影響、家人抱怨等。
在量表發展部分，首先利用刪題及選題技巧，刪除了與總分相關值太低和鑑別力太低的題目共7題，再透過因素分析決定了3個因素（分量表），依次命名為『知覺控制』，『生活影響』，及『戒斷症狀』。本量表之建構效度以攝食量為效標:攝食量與分量表之相關係數呈顯著正相關，另信度分析方面由於『生活影響』分量表之內部一致性太低，故刪除之，最後得16題題本，包括『知覺控制』（α係數=.8626）和『戒斷症狀』（α係數=.8496）兩個分量表。

The relation between betel-quid chewing and addiction has been supported by several studies recently. However, most of the researches related to betel-quid chewing in Taiwan has focused on pathogenesis or physical mechanism of oral cancer. The purpose of this study was to understand the characters of addictive behavior of betel-quid chewer’s and to develop an areca dependence questionnaire.
According to the basis of dependence theory, qualitative interviews were conducted to 24 betel-quid chewers in order to understand how they became chewers and what life experiences they have had. After in-depth interviews, an areca dependence questionnaire was developed accordingly.
Results showed that the chewer’s addictive behaviors can be divided into three categories: 1) withdrawal symptoms including oral discomfort and physically effect, 2) loss of control including continuing chewing, craving, and attempts to quit, 3) salience including effects of health and family complaints.
Twenty-seven items of areca dependence questionnaire was initially developed. The wording of the questionnaire was first pre-tested by interviewing 20 betel-quid chewers and then was re-tested by a sample of 154 adult chewers. To develop an areca dependence questionnaire, a technique of low acceptance score of item-total correlation and low power of discrimination were used. Thus seven items were deleted. Through factor analysis, three significant factors were identified. We named factor one was ‘perceived ontrol’, factor two was ‘obvious effect’, factor three was ‘withdrawal symptom’. Since internal consistency of subscale ‘obvious effect’ was too low, we decided to delete it. Finally, we got an 16-item questionnaire including two subscales which was ‘perceived control’(cronbach’s α=0.8626) and ’withdrawal symptom’(cronbach’s α=0.8496).

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