Abstract
BackgroundChewing khat leaves is often accompanied by tobacco use. We assessed aspects of tobacco use and explored factors associated with tobacco use patterns (frequency of use per week) among khat chewers who used tobacco only when chewing khat (“simultaneous tobacco and khat users”, STKU).MethodsA sample of 204 male khat chewers was recruited during random visits to khat outlets. Data collected included socio-demographic items, tobacco use and khat chewing behaviours. Both psychological and physical dependence on khat were assessed using the Severity of Psychological Dependence on Khat (SDS-Khat) Scale, the Diagnostic Statistical Manual IV (DSM-IV) and adapted items from the Fagerström Test for Nicotine Dependence (chewing even when ill, and difficulty in abstaining from khat chewing for an entire week). Descriptive statistics and non-parametric analyses were conducted.ResultsOf the 204 khat chewers, 35% were khat chewers only, 20% were STKU, and the remainder were daily cigarette smokers. The mean age of STKU was 38.12 (±14.05) years. Fifty seven percent of STKU smoked tobacco and chewed khat for two days per week and 43% smoked and chewed more frequently (three to six days: 33%, daily: 10%). Three quarters (74%) were former daily tobacco users. Khat chewing initiated tobacco smoking among 45% of STKU and 71% reported attempts to quit tobacco smoking during khat chew. Among STKU, smoking tobacco for more than two days per week was significantly associated (p < 0.05) with psychological dependence (increased levels of SDS-Khat), physical dependence (increased levels of DSM-IV symptoms, chewing even when ill, difficulty in abstaining from chewing for an entire week and self-reported health conditions) and behavioural factors (e.g. amount of khat chewed in typical khat session).ConclusionsKhat chewing may promote different patterns of tobacco smoking, initiate and sustain tobacco smoking, and trigger tobacco cessation relapses among STKU. Increased frequency of tobacco smoking among STKU was linked to psycho-physical and behavioural factors. Further investigation within large and representative samples of both sexes of STKU in different contexts should be considered for health research and policy development. Khat chewing should be considered when designing tobacco prevention uptake, cessation interventions and relapse prevention programmes.
Highlights
Chewing khat leaves is often accompanied by tobacco use
Chewing khat leaves, which have ‘amphetamine like’ effects [6], is a social activity practiced by Yemenis, Somalis, Ethiopians and other East African communities both in their original countries and within the diasporas [7,8]
We only encountered Yemeni khat chewers with the exception of one Somali male who was excluded from the study
Summary
Chewing khat leaves is often accompanied by tobacco use. Chewing khat leaves, which have ‘amphetamine like’ effects [6], is a social activity practiced by Yemenis, Somalis, Ethiopians and other East African communities both in their original countries and within the diasporas [7,8]. Khat chewing sessions are often held in groups that segregate male and female chewers based on cultural norms [9]. These sessions, which are often held in the afternoon and may continue for 5–6 hours, play socio-cultural roles that include resolving social conflicts and exchanging ideas [10]. Other functions of khat chewing include enhancing concentration among students when studying [11] and, among females, the relieving of social and mental stress [12] and demonstration of the passage into womanhood
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
