嚼食檳榔的脈絡分析:一個對台北地區計程車司機的田野研究

Abstract

嚼食檳榔與口腔癌的關係，近年來已成為公共衛生領域內重要的議題。由於台灣有關檳榔的研究中，針對使用者或是圈內人觀點的研究較少，也缺乏探討檳榔與嚼食者日常生活脈絡的關係，為了更真實貼近一般嚼食檳榔的勞動者，本研究以嚼檳榔計程車司機為研究對象，透過深入訪談、非正式訪問、以及較長時間的參與觀察，強調社會結構與個人健康行為互動的關係，來探討他們的嚼檳榔行為。

Recently, the relationship of areca quid chewing and oral cancer has become an important issue in public health. Previous studies in Taiwan, however, had hardly ever explored areca quid chewers’ risk perspectives, and how the chewing behavior was embedded in the social context of their everyday lives. This research collected data from areca quid chewing taxi drivers and focused on areca quid chewers’ daily lives. With in-depth interview, observation and informal interview, this study examines the relationship between social structure and agents in which areca quid chewing habits were embedded. Accompanied by an ex-taxi driver, I visited taxi drivers’ rest areas and waiting lines in Taipei. There were four major parts in the study. In Part one, I described the relationship between social position, job “choice” and areca quid chewing of 44 areca quid chewing taxi drivers who were in-depth interviewed. In Part two, I explored these areca quid chewers’ daily work context in which the consumption of areca quid was embedded. I learned from the participants that the consumption of areca quid was a “border” that differentiates between the work and non—work context, and it was also a vehicle for social interaction and a symbol of group identity. In Part three, I examined areca quid chewing taxi drivers’ perspectives of areca quid related health risk information. These taxi drivers integrated areca quid risk information with their personal health knowledge and daily experiences, reinterpreted areca quid risk information, and took action. In part four, I explored the relationship of their health promoting behaviors and risk behaviors. Taxi drivers were likely to use more than one substance to cope with their stressful lifestyle, and usually did not focus on a single behavioral effect on their overall health. Instead, they tended to assess their health and the risks they encountered from a holistic perspective. In sum, this study concentrates on social structure that constrains individual health-related behavior from the chewers’ point of view. This research aims to provide public health professionals with a new perspective to investigate health-related behavior. I suggest that areca quid chewing cannot be treated simply as an isolated “behavior”. Rather, it operates within the world of structured contexts determined by individual chewers’ social position. The finding provides a sociological perspective in public health research, and holds implications for health promotion polices and theories.