Objectives: This study was to investigate the prevalence of betel quid chewing and workplace relevant factors among transportation workers in central Taiwan. Methods: A cross-sectional survey was taken of residences in Changhua, Yunlin and Nantou, which have a higher prevalence of betel quid chewing in Taiwan. Six hundred ninety-eight transportation workers, recruited by a random stratified sampling, completed the interview (71.0%). Results: The prevalence of transportation workers’ chewing was 22.0%, and 81.7% of betel quid chewers were also cigarette smokers. A survey of factors relevant to the workplace revealed that the chewing transportation workers sustain betel quid use because of long-distance transportation (81.1%), stimulation to counteract boredom (78.0%), long working hours (27.2%), demands of physical strength (17.3%), stress and tension (26.4%), and unchanging routine work (16.3%). The chewing transportation workers mentioned that prolonged sitting (44.9%) and repetitive action (26.9%) made them continue to chew betel quid. In logistic regression, betel quid chewers with a drinking habit and prolonged sitting had a higher risk to chew betel quid (OR=3.36, 95%CI=1.01-11.18; OR=5.31, 95%CI=1.67-24.15). Conclusions: Most of the betel quid chewing transportation workers were also cigarette smokers. Around half of the chewers can obey the workplace prohibition to abstain from chewing betel quid. Regarding the results in this study, it is recommended to promote the abstention of both betel quid chewing and cigarette smoking. For the workplace, it is recommended to prohibit betel quid chewing at the workplaces, and regulate the working time and working matters to reduce chewers to use betel quid.