Journal of Sustainable Social Change




Background: After alcohol, tobacco, and caffeine, areca or betel nut is the fourth most commonly abused substance in the world. The prevalence of betel nut use in the Solomon Islands is estimated at 68% in young people. Long-term use can result in detrimental health outcomes such as oral cancers and metabolic syndrome.

Methods: The purpose of this quantitative cross-sectional study was to determine whether the constructs of social cognitive theory (SCT) can predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, self-efficacy to overcome barriers, self-control, and environment were used to build a model for the study. Data were collected from a convenience quota sample of 138 Year 12 secondary students through a 37-item questionnaire.

Results: Multiple linear regression and multiple logistic regression analysis indicated self-efficacy to overcome barriers (p < .01) was the only construct significantly related to intent to not chew betel nut.

Conclusion: Social cognitive theory (SCT) was weakly predictive with low explained variance for not chewing betel nut in secondary students. Research findings contribute to knowledge useful for developers of school health programs and researchers working on strategies to improve intervention actions to reduce betel nut use. The SCT could be bolstered by newer theories like the integrative model or multi-theory model (MTM) of health behavior change for designing educational interventions aimed at limiting betel nut use in young people, especially school students.