Pfeiffer, JamesBirmingham-Babauta, Samantha A'ani2022-07-142022-07-142022-07-142022BirminghamBabauta_washington_0250O_24241.pdfhttp://hdl.handle.net/1773/48679Thesis (Master's)--University of Washington, 2022An estimated six hundred million people across the globe chew betel nut (areca nut). Additionally, betel nut chewing has strong cultural ties in the Pacific Islands and South and East Asia. Many believe it offers positive benefits like stimulating alertness, relaxation, and a way to manage stress. However, betel nut is a Group 1 carcinogen, and an estimated 43% of adults report chewing in the Commonwealth of the Northern Mariana Islands (CNMI). CNMI data shows that Non-communicable diseases (NCDs) are the leading cause of death, with cancers contributing to 18% of the deaths. Data from 2007 to 2016 shows that cancers of the oral cavity account for 13% of the cancer-related in the CNMI. Though we know that chewing betel nut (pugua) causes cancer, its addictive properties as a psychostimulant, cultural ties in Micronesia, and influences in social settings make giving up this habit a difficult feat. Minimal research is available on betel nut chewing in Micronesia, specifically in the CNMI, and existing research is focused mainly on Guam. Taking a closer look at the experiences people have had with self-driven betel nut cessation may offer insight into how local public health departments and partners can offer community-led and culturally adapted services to assist with quitting betel nut.application/pdfen-USCC BYArcea NutBetel NutCommunity-Based ResearchCultural LensPublic healthGlobal HealthThesis