Intention to stop khat chewing and associated factors among khat chewers in Gondar city, northwest Ethiopia: using Trans Theoretical Model

Abstract Background Khat chewing practice is rapidly increasing worldwide and currently an estimated over 10 million people chew khat. Trans Theoretical Model (TTM) is a promising model to assess the of stages of behavior change is a combination of intention. Given a sufficient control over the behavior, people carry out their intentions when the enabling environments arises. Assessing intention to quit chewing khat, motivational factors that influence behavior, is important to design effective interventions. Methods Community-based cross-sectional study was conducted from March to April 2019 in Gondar city, northwest Ethiopia. Six hundred five khat chewers were selected from six kebeles using cluster sampling method. Structured interviewer-administered questionnaire was used to collect data. Bivariate and multi-variable logistic regression model were fitted. Adjusted Odds ratio (AOR) with 95% confidence interval and p-values <0.05 in the multi-variable model were used to declare significant association. Results Out of the total participants, 69.3% (95% CI: 65.8-72.9) had intention to stop khat chewing within six months from the day of interview or before. Majority of the study participants 55.4% were on contemplation stage. Higher self-reevaluation [AOR=2.8, (95%CI: 1.6-5.0)], environmental reevaluation [AOR=1.9, (95%CI: 1.1-3.3)] and social liberation [AOR=1.8, (95% CI: 1.0-3.1)] process of changes were associated with intention to quit khat chewing. In addition, using additional substances and start chewing at earlier age were associated with lower intention to quit chewing. Conclusion Majority of the khat chewers had the intention to stop khat chewing. Increased self-reevaluation, environmental reevaluation and social liberation process of changes enhance the intention of quitting khat chewing. Thus, stage-based interventions should be done to motivate Khat chewers to stop khat chewing.