Multidimensional harms of khat use in Ethiopia: an exploratory sequential mixed methods study design

Abstract Background: High prevalence of khat use is reported in Yemen, Somalia and Ethiopia; 67.9%, 59%, and 16% respectively. Previous studies mainly focused on khat users’ perspectives and were limited to individual-level harms. This study aimed to assess and explore the individual and societal level harms of khat use in comparison to people who do not use khat. Methods: Exploratory sequential mixed methods study design was employed in Addis Ababa, Ethiopia. A random sampling method was used to select households and individuals in the household. The final sample size for individuals who chew khat was 512 and 380 individuals who do not use khat. All qualitative participants were purposively selected based on their khat user behavior. Twelve participants participated in the in-depth interviews. Independent sample t-test and Chi-square test were used to examine the difference between khat users and non-khat users across different indicators of the harms of khat use. Results: There were more depression symptoms, disability, stressful life events and food insecurity among individuals with khat us compared to non-khat users (p<0.05). Participants also reported diverse socioeconomic adverse consequences of khat use including selling one's assets or home utensils and spending the money on khat, low motivation for work, work abstinence, family chaos and conflict, unemployment, and violation of socio-cultural values and norms. Conclusion: The study found multidimensional harms of khat use. Individuals who chew khat were more prone to psychological, and socioeconomic adversities. Prevention, law regulation or harm reduction actions that avoid or curve the harms of khat use should also be well designed and implemented at different levels.