Despite thousands of years of coca leaf chewing by rural inhabitants of the Andes Mountains, there is much to explore in the epidemiological research on this ancient habit. This is the first study about the epidemiology of coca leaf chewing and its health consequences that uses both a large representative random sample of the Andean rural highlanders of Peru, and the new ICD-10 diagnostic criteria for dependence syndrome. This secondary data analysis study has three specific aims: (1) to estimate basic epidemiologic parameters of the quantity of coca leaf chewing. (2) To estimate subgroup variations of the epidemiological parameters of the quantity of coca leaf chewing according to characteristics of person and place. (3) To estimate the degree to which coca leaf chewing might cause ICD-10 dependence syndrome and impairment in the quality of life.The results show that coca leaf chewing is common and not evenly distributed among the Andean highlanders. Males, elders, and Ayacuchans are the most active coca leaf chewers. Furthermore, 2.3 percent of ever coca leaf chewers have ICD-10 dependence syndrome, and this dependence syndrome has compromised their quality of life. It is still premature to conclude that coca leaf chewing produces addiction. These initial findings should be followed by rigorous causal studies to assess the clinical features of coca leaf chewing dependence syndrome and its potential harmful physical consequences for the users.
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