Abstract
Background: Khat chewing practices are common in the Arabian Peninsula and in Eastern Africa, including Ethiopia. Khat chewing is popular among adolescents in Ethiopia. However, there are no studies on the practice of Khat chewing among early adolescents in school children in the eastern part of the country, where the majority of khat in the country is produced and exported. Objective: This study aimed to assess khat chewing and associated factors among early adolescent school children in Haramaya district from September 1 to 30, 2023. Methods and Materials: A school-based cross-sectional study was conducted in Haramaya District from September 1 to 30, 2023. A total of 592 early adolescent school children were selected sampling technique with simple random sampling. Trained data collectors collected data structured questionnaires. The data were entered into EpiData version 4.6. The data were then exported to the SPSS version 23 statistical package for further data processing and analysis. Descriptive statistical tests and bivariate and multivariate logistic regression analyses were used to determine predictors of Khat chewing among early adolescents. The level of significance was set at a P value of less than 0.05. Results: The current prevalence of khat chewing was 38.9% (CI: 34.0%-42.1%). Among the studied variables, male sex [AOR=2.47; 95% CI: (1.61-3.86)], peer pressure [AOR=3.67; 95% CI: 2.45-5.40)], easy availability of khat [AOR=1.95; 95% (1.01-3.78)], and living with khat chewers [AOR=7.48; 95% CI: (4.60-12.16)] were significantly associated with current khat chewing practices. Conclusion: Khat chewing is prevalent among early adolescents in elementary school in the study area. The factors most strongly associated with khat chewing were male sex, peer pressure, living with khat chewers and easy availability of khat. The findings suggest the need to create public awareness among the community, particularly for adolescents and their parents.
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Published in
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Science Journal of Clinical Medicine (Volume 14, Issue 3)
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DOI
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10.11648/j.sjcm.20251403.11
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Page(s)
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27-39 |
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Creative Commons
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
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Copyright
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Copyright © The Author(s), 2025. Published by Science Publishing Group
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Keywords
Khat Chewing, Early Adolescence, Students, Associated Factors, Haramaya, Ethiopia
1. Introduction
The khat (
Catha edulis) is an evergreen tree of the Celastracea family that is cultivated mainly in East Africa and the Arabian Peninsula
| [1] | Silva B, Soares J, Rocha-Pereira C, Mladěnka P, Remião F, Researchers O. Khat, a cultural chewing drug: a toxicokinetic and toxicodynamic summary. Toxins. 2022; 14(2): 71. https://doi.org/10.3390/toxins14020071 |
[1]
. Cathinone and cathines are the two primary chemicals found in khat leaves. Both are structurally related to the effects of amphetamine on the human nervous system
| [2] | Warku Badada FdA, Ephrem Engidawork, Jemal Hussein, Adrian, LLerena, Eleni Aklillu. Effects of Khat (Catha edu- lis) use on catalytic activities of ma- jor drug-metabolizing cytochrome P450 enzymes and implication of pharmacogenetic variations. 2018. https://doi.org/10.1038/s41598-018-31191-1 |
[2]
, resulting in euphoric feelings, excessive enthusiasm and increased energy and alertness
| [3] | Wondemagegn AT, Cheme MC, Kibret KT. Perceived psychological, economic, and social impact of khat chewing among adolescents and adults in Nekemte Town, East Welega Zone, West Ethiopia. BioMed research international. 2017; 2017. https://doi.org/10.1155/2017/7427892 |
[3]
. In Ethiopia, khat is a stimulant that is widely grown and commonly used for social recreation and religious rituals
| [4] | Atnafie SA, Muluneh NY, Getahun KA, Woredekal AT, Kahaliw W. Depression, anxiety, stress, and associated factors among khat chewers in Amhara region, Northwest Ethiopia. Depression research and treatment. 2020; 2020: 1-12. https://doi.org/10.1155/2020/7934892 |
[4]
.
Khat is widely consumed by Ethiopian adolescents for different purposes; students chew quickly, believing that it improves memory, alert-ness, and clear thinking
| [5] | Engidawork E. Pharmacological and toxicological effects of Catha edulis F.(Khat). Phytotherapy Research. 2017; 31(7): 1019-28. https://doi.org/10.1002/ptr.5832 |
[5]
; however, it has many negative effects on different body systems. Khat chewing has major effects on the gastrointestinal system, such as dental problems, mouth ulcers, gastritis, hemorrhoids, constipation, liver disease, and intestinal obstruction of the central nervous system; alertness, tolerance, dependence, anxiety, depression, delusion and insomnia. In the cardiovascular system, excessive use of khat also causes hypertension, arrhythmia, myocardial infarction, stroke and death
. Few studies on appetite hormones have reported that regular users of khat may experience reduced hunger and increased fullness
| [7] | Bereda G. Catha Edulis Forsk and its adverse effects on health: current and ongoing factuality. Ann Clin Med Case Rep. 2021; 7(13): 1-10. |
[7]
, but it may also interfere with nutrition and absorption, potentially leading to malnutrition
| [8] | Muñoz MJR. Controlling thought and action: a perspective from khat users and cocaine users: Universidad de Granada; 2015. |
[8]
.
Drug abuse (khat chewing) throughout early adolescence can also have an impact on the youth's family, community, and society as a whole
| [9] | WHO. Adolescents and young adults health key facts. In: World Health Organization [Internet]. 2021. 2021. |
[9]
. Currently, the Ethiopian government has not put in place an efficient plan to lower or regulate khat consumption, despite the negative effects that chewing khat has on one’s health and society
. The only measure it has taken is placing high taxes on the trade of khat.
Khat is widely produced in the study area, Haramaya district, Ethiopia, and many early adolescents in the region use it for various reasons. In the study area, khat use is widely accepted and encouraged, with users relying on it for energy to cultivate and sell more khat, creating a self-sustaining cycle. On the basis of simple observations, khat users are physically tiny and bony, probably because the chemicals in khat may suppress their appetite. Globally, khat chewing leads to a loss of work hours, decreased economic production, divorce, health problems, conflicts and malnutrition
| [11] | Besha T. Socioeconomic, Health, and Missiological Implications of Khat in East Africa. Pan-African Journal of Health and Environmental Science. 2022; 1(2): 39-52. https://orcid.org/0000-0002-8079-5223 |
[11]
. In Yemen and East Africa, chewing khat poses a serious health risk to millions of people
| [12] | Al‐Maweri SA, Warnakulasuriya S, Samran A. Khat (Catha edulis) and its oral health effects: An updated review. Journal of investigative and clinical dentistry. 2018; 9(1): e12288. https://doi.org/10.1111/jicd.12288 |
[12]
. Khat users suffer from serious negative impacts on their social, physical, and mental health. Owing to its economic importance, it is currently grown for both local and export markets, which poses a challenge. Control over crops may become more difficult as export potential increases
| [5] | Engidawork E. Pharmacological and toxicological effects of Catha edulis F.(Khat). Phytotherapy Research. 2017; 31(7): 1019-28. https://doi.org/10.1002/ptr.5832 |
[5]
.
In Ethiopia, 85-90% of the khat produced is exported, contributing significantly to the country's foreign exchange earnings
| [13] | Lamina R, Lamina S. The Chewing of Khat (Catha Edulis) in the horn of Africa and Arabian Peninsula: economic overview. Arabian Journal of Business and Management Review (OMAN Chapter). 2013; 3(2): 80. |
[13]
. However, several studies have shown that chewing khat has negative physical and psychological repercussions that are detrimental to both the individual and the community
| [14] | Sikiru L, Babu SM. Khat (Catha edulis): academic, health and psychosocial efects on “mature” students. African Journal of Drug and Alcohol Studies. 2009; 8(2). https://doi.org/10.4314/ajdas.v8i2.52932 |
[14]
.
In Ethiopia, Khat is the second most widely used psychoactive substance after alcohol. Psychoactive substance (khat, cigarettes and alcohol) use in the early stages of adolescence increases the risk of developing addiction, mental disorders, and substance use disorders
| [15] | Fiidow OA, Minhat HS, Zulkefli NAM, Ahmad N. A systematic review on risk factors for khat chewing among adolescents in the African continent and Arabian Peninsula. Plos one. 2022; 17(2): e0263372. https://doi.org/10.1371/journal.pone.0263372 |
[15]
. Another study revealed that using khat in the early stages of adolescence is linked to addiction later in adult life
| [16] | Ogundipe O, Amoo E, Adeloye D, Olawole-Isaac A. Substance use among adolescents in sub-Saharan Africa: A systematic review and meta-analysis. South African Journal of Child Health. 2018; 2018(1): s79-s84. https://hdl.handle.net/10520/EJC-10deb396ce |
[16]
. Substance misuse and related problems are currently a global concern since they may lead to mental health disorders in individuals aged 10-19 years, accounting for 1 in 7 (14%) of all illnesses worldwide
| [9] | WHO. Adolescents and young adults health key facts. In: World Health Organization [Internet]. 2021. 2021. |
| [17] | Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The lancet. 2013; 382(9904): 1575-86. https://doi.org/10.1016/S0140-6736(13)61611-6 |
[9, 17]
.
Numerous studies have shown that chewing khat is linked to male sex, peer pressure, similar habits among family members, and the availability of khat around residential areas
| [18] | Birhanu A TB, Addis Eyeberu, Tamirat Getachew, Elias Yadeta, Abraham Negash, Magarsa Lami, Tegenu Balcha, Addisu Sertsu, Adera Deballa. Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. 2023. https://doi.org/10.2147/SAR.S401843 |
| [19] | Nigussie K, Negash A, Sertsu A, Mulugeta A, Tamire A, Kassa O, et al. Khat chewing and associated factors among public secondary school students in Harar town, Eastern Ethiopia: a multicenter cross-sectional study. Frontiers in Psychiatry. 2023; 14: 1198851. https://doi.org/10.3389/fpsyt.2023.1198851 |
[18, 19]
. Muslims, age, living in rural areas, parental education, school grade, parental occupation, having friends chew khat and smoking
| [20] | Astatkie A, Demissie M, Berhane Y, Worku A. Prevalence of and factors associated with regular khat chewing among university students in Ethiopia. Substance abuse and rehabilitation. 2015; 6: 41. https://doi.org/10.2147/SAR.S78773 |
| [21] | Shiferaw LD. Social Factors Contributing to Students’ Substance Abuse in Dire Dawa University. Research on Humanities and Social Sciences. 2022; 12. |
| [22] | Zerihun E, Tesema K. Substance use and associated factors among Adolescents’ during the Covid-19 pandemic in Eastern Ethiopia: A cross-sectional study. medRxiv. 2022: 2022.03. 29.22273151. https://doi.org/10.1101/2022.03.29.22273151 |
[20-22]
and peer substance use were found to be positively correlated with increased early adolescent drug use
. Chewing khat could result in addiction to other substances and drugs. Some people who chew khat consume alcohol, cigarettes, hashish, shisha, and other powerful habit-forming substances
| [24] | Admassie y. The Khat Conundrum in Ethiopia: Socioeconomic Impacts and Policy Directions. 2018(12): 146. |
[24]
.
Although khat is popular among adolescents in Ethiopia, only a few studies have investigated its prevalence in different sections of the community. In particular, in eastern Ethiopia, the majority of khat in the country is produced and exported abroad
| [25] | Reda AA, Moges A, Biadgilign S, Wondmagegn BY. Prevalence and determinants of khat (Catha edulis) chewing among high school students in eastern Ethiopia: a cross-sectional study. PLoS one. 2012; 7(3): e33946. https://doi.org/10.1371/journal.pone.0033946 |
[25]
. There is little information available for elementary school early adolescent students regarding "khat" chewing, although it has been discussed and written about extensively among postprimary, elementary school, and nonstudent populations. As a result, this study offered information on khat chewing among early adolescents and the factors related to it. The present study can fill this gap in knowledge about khat chewing and its associated factors among elementary school early adolescent students. However, no study has investigated khat chewing and its associated factors among early adolescents. Therefore, this study aimed to assess khat chewing and its associated factors among elementary school early adolescent students.
2. Methods and Materials
2.1. Study Setting and Period
The Haramaya district in Eastern Ethiopia's Oromia Region's East Hararghe zone served as the study location. The Haramaya district is located 500 km away from Addis Ababa, the capital city of Ethiopia. It shares borders with the Kurfa Chele district to the south, Kersa to the west, Dire Dawa to the north, Kombolcha to the east, and the Harari region to the southeast. There are 32 rural and 2 urban kebeles in the Haramaya district. According to the data obtained from the woreda's health office, the total population of the woreda in 2012 (E.C.) was estimated at approximately 310,363, of which 155379 were males and 154984 were females. Approximately 29% of the total population was between 10 and 19 years old (89900). There is one university, two high schools, and 76 elementary schools, totaling 66520 male and female students. Enrolled and registered for the 2015 EC academic year.
A survey of the land in Haramaya woreda revealed that 36.1% of the land was arable or cultivable, 2.3% was pasture, 1.5% was forest, and the remaining 60.1% was considered built-up, degraded or otherwise unusable. Khat, vegetables and fruits are important cash crops. Kombolcha and Haramaya are major producers of khat and vegetables. Study was conducted from September 1 to 30, 2023.
2.2. Study Design
A school-based cross-sectional study design was conducted.
2.3. Source Population
The source population of the study was all early adolescents enrolled in elementary schools in the Haramaya districts.
2.4. Study Population
The study population included all early adolescents registered for the academic year of 2023.
2.5. Inclusion Criteria
All early adolescents aged 10-14 years who provided parental consent to participate in research from the selected elementary schools were included.
2.6. Exclusion Criteria
Early adolescents who were unable to respond due to critical illness during data collection were excluded from the study.
2.7. Sample Size Determination And Sampling Method
The sample size of the first objective was calculated single population proportion formula, which considers a 24.5% prevalence of khat chewing, as in a similar study
| [25] | Reda AA, Moges A, Biadgilign S, Wondmagegn BY. Prevalence and determinants of khat (Catha edulis) chewing among high school students in eastern Ethiopia: a cross-sectional study. PLoS one. 2012; 7(3): e33946. https://doi.org/10.1371/journal.pone.0033946 |
[25]
. A 0.05 level of significance and 0.05 marginal error at the 95% confidence level were used, and a 10% nonresponse rate was added as follows:
Where,
n= minimum sample size required for study
p= estimated prevalence from the literature 24.5% (0.245)
Z α/2 = critical value at the 95% confidence level of certainty (1.96).
d= margin of error 5%% (0.05).
Thus, n is calculated as:
= 266
The ultimate sample size, after adding a 10% nonresponse rate, was 296.
The sample size for the second objective, which refers to factors related to khat chewing, was determined using the Epi Info statistical software version 7 statistical calculation with the following assumptions for some of the factors related to khat chewing that were gathered from various types of literature. Assuming a 95% confidence interval, 80% power, and a 1:1 ratio of exposed to unexposed. Finally, the bigger sample size of 296 was utilized for this study out of the two objectives of prevalence (296) and associated factors (273); take into consideration the design effect of 2 (296*2) =592.Consequently, 592 people contributed to the study's final sample size.
First, 11 schools were chosen using a simple random sampling technique out of the district's 76 schools. Thus, Karo Tarkanfi Elementary School, Karsa Gata Elementary School, Finkle Elementary School, Kerensa Dareba Elementary School, Kurro Haro Elementary School, Amuma Elementary School, Karo Dada Elementary School, Adele 01 Elementary School, Chaleyssa Elementary School, Sharif Khalid Elementary School, and Dire Kabso Elementary School are the districts (schools) that were chosen. In accordance to the number of students in the classroom, children from grades 7 and 8 were chosen for the second stage using simple random sampling procedure. Following that, the names of each chosen elementary school and their unique code number were used to frame each early adolescents (
Figure 1).
Figure 1. Schematic presentation of sampling procedure of early adolescents in elementary school students in Haramaya District, Oromia, Ethiopia, 2023.
2.8. Study Variables and Measurements
After a thorough analysis of related research instruments and an understanding of the study's objectives, self-administered questions were created
| [25] | Reda AA, Moges A, Biadgilign S, Wondmagegn BY. Prevalence and determinants of khat (Catha edulis) chewing among high school students in eastern Ethiopia: a cross-sectional study. PLoS one. 2012; 7(3): e33946. https://doi.org/10.1371/journal.pone.0033946 |
| [26] | Teshome G. Magnitude and Factors Associated With Khat Chewing Among Students of Adama University, Oromia National Regional State: Addis Ababa University; 2012. |
[25, 26]
. A WHO student drug-use survey was used to guarantee validity. The questionnaire asked questions about behavioral factors, environmental factors, motives for chewing khat, and sociodemographic features.
The WHO student drug use questionnaire was modified into a structural questionnaire
| [27] | WHO. A methodology for student drug-use surveys. 1980. |
[27]
, and related research instruments were employed. English and Afan Oromo were used to translate the questionnaire. Finally, the questions remain consistent, and clear language is used in the translation from the Afaan Oromo version to the English version.
2.9. Operational Definitions
Current khat chewing: Students who chew Khat within 30 days preceded the study
.
Adolescents: population aged 10-19 years
| [9] | WHO. Adolescents and young adults health key facts. In: World Health Organization [Internet]. 2021. 2021. |
[9]
.
Early adolescents: population aged between 10 and 14 years
| [9] | WHO. Adolescents and young adults health key facts. In: World Health Organization [Internet]. 2021. 2021. |
[9]
.
Primary education is classified into the primary first cycle, which encompasses grades 1--4, and the primary second cycle from grades 5-8
| [29] | MOH. Ethiopian School Health Program Framework, federal demoratic republic of ethiopia, minstry of health. August 2017. 2017: 118. |
[29]
.
2.10. Data Collection Procedures
Training was given for data collectors and supervisors, how to interview and how to approach to the participants. Data were collected using face to face interview using semi-structured structured questionnaire. Data were collected by using Afan Oromo version of questionnaires.
2.11. Data Quality Control
Before the main study was conducted, a pretest was performed on thirteen cases from near school, which were not included in the main study. The pretest was performed on 5% of the sample size before the data collection period. On the basis of the pretest results, the questionnaire was modified as necessary. The data collectors informed the students about the objective of the study and then administered the questionnaire. The collected data were checked for completeness and consistency.
2.12. Data Processing and Analysis
The data were checked for completeness, clarity, and consistency. The data were entered into EpiData Version 4.6 and analyzed using SPSS Version 23 software. Descriptive statistics were conducted to describe the characteristics of the participants accordingly. A bivariable logistic regression analysis was performed to determine the associations between the dependent variable and each independent variable. The collinearity effect was checked by the variance inflation factor (VIF), and non-collinear covariates were included in the independent final binary logistic regression model to assess the possible associations of outcome variables. All variables that were significant at p values < 0.25 in the bivariable analysis were considered for multivariable analysis to control all possible confounders. Adjustments along with 95% intervals were estimated to identify factors associated with the outcome variable multivariate logistic regression. The level of statistical significance was defined as a p value less than 0.05.
2.13. Ethical Clearance
The study was carried out under consideration of the Helsinki Declaration of medical research ethics. Ethical clearance was obtained from the institutional health research ethics review committee (IHRERC)/116/2022 of the College of Health and Medical Science, and a written permission letter was obtained from the Haramaya Woreda Education Office for each selected school's cooperation during the data collection period. All study participants' information was given about the study before the data were collected on its possible risk, benefit, confidentiality, privacy, voluntary activity, right to withdrawal, and time the questionnaire was taken, and then informed, voluntary, written, and signed consent was obtained from each participant’s parent or guardian before starting the data collection. Personal identification was written on the questionnaire, and all information that was obtained from them was kept confidential for the study participants. In the event that individuals are found to be addicted to khat chewing, their awareness of the disadvantages of khat chewing and other associated risk factors should be increased to change their attitudes toward khat chewing at all selected schools.
3. Results
3.1. Sociodemographic Characteristics of Early Adolescents
A total of 592 students participated in this study, yielding a response rate of 100%. More than half of the students (350, 59.1%) were in Grade 7. Two hundred forty-two patients (40.9%) were Grade 8. The mean age of the students was 13.61 (± 0.58 SD) years, ranging from 12--14 years. The majority 560 (94.8%) of the students who participated were aged 13--14 years. More than half of the students (390, 66.9%) were males.
The main ethnicity group was Oromo, accounting for 564 (95.3%) individuals, followed by Amara, which accounted for 28 (4.7%) individuals. Approximately 556 (93.9%) and 33 (5.6%) of the sampled students were Muslim and Orthodox Christian, respectively, followed by protestant followers 2 (0.2%). Among the students who participated in this study, 569 (96.4%) were single. A total of 426 (72.3%), 80 (13%), and 45 (7.6%) fishermen were the main sources of household income. The majority, 519 (87.7%), were living with their parents (
Table 1).
Table 1. Sociodemographic characteristics of early adolescents in elementary school students in Haramaya District, Oromia, Ethiopia, 2023 (n=592).
Variables | Frequency | Percent (%) |
Age (in years) | 10-12 yrs. Old | 32 | 5.6% |
13-14yrs. Old | 560 | 94.4% |
Sex | Male | 390 | 65.9% |
Female | 202 | 34.1% |
Grade | Grade 7 | 350 | 59.1% |
Grade 8 | 242 | 40.9% |
Ethnicity | Oromo | 564 | 95.3% |
Amhara | 28 | 4.7% |
Religion | Muslim | 556 | 93.9% |
Orthodox | 35 | 5.9% |
Others | 1 | 0.2% |
Marital status | Single | 582 | 98.3% |
Married | 9 | 1.5% |
Divorce | 1 | 0.2% |
Residence | Rural | 372 | 62.8 |
Urban | 220 | 37.2 |
Family’s main source of income | Farmers | 428 | 72% |
Government employee | 46 | 7.8% |
Daily Labore’s | 38 | 6.5% |
Merchants | 80 | 13% |
Others | 1 | 0.5% |
Educational status of father | No formal education | 81 | 13.7 |
Primary school (1-8) | 463 | 78.2 |
Secondary school (9-12) | 27 | 4.6 |
Diploma | 11 | 1.9 |
Degree and above | 9 | 1.5 |
Educational status of mother | No formal education | 128 | 21.6 |
Primary schoo l (1-8) | 441 | 74.5 |
Secondary school (9-12) | 13 | 2.2 |
Diploma | 8 | 1.4 |
Degree and above | 2 | .3 |
Living with | Family | 519 | 87.7% |
Relative | 46 | 7.8% |
Friend | 10 | 1.7% |
Husband | 12 | 2% |
Alone | 5 | 0.8% |
3.2. Prevalence of Khat Chewing
The current prevalence of khat chewing was 230 (38.9%) [95% CI: 34.9%-42.9%]; the current prevalence of khat chewing among male students was 174 (29.4%), and that among female students was 56 (9.4%). Almost all 222 (96.5%) of the students among the current chewers were between 13 and 14 years old. Among the students who were current chewers, 56 (24.3%) and 163 (70.9%) reported that they chewed daily a week and one to three times a week, respectively. The majority (n=206, 89.6%) of the chewers chewed with school friends, 5 (2.2%) chewed with friends out of school, 11 (4.8%) chewed alone, and 3.5% chewed with their parents. Students who obtained khat—almost half of the chewers—110 (47.8%) and 94 (40.9%)—got khat from their family and the khat farm, respectively.
Among the main reasons given by the current respondents for starting chewing khat, 1.3% (n=3) reported khat to kill time, 10.9% (n=25) reported khat for socialization, 12.1% (n=31) reported khat because of easy availability, 46.5% (n=107) reported khat for study purposes, 19.1% (n=44) reported khat for peer pressure, 5.2% (n=12) reported khat to increase performance and concentration, and 3.9% (n=8) reported khat for religious purposes (
Table 2).
Table 2. Characteristics of current khat chewing among early adolescents in elementary school students in Haramaya District, Oromia, Ethiopia, 2023.
Variables | Current khat chewers | Percent (%) |
Male (n %) | Female (n %) |
Khat chewing frequency | Every Day/Daily | 38(21.8%) | 18(32.1%) | 56 (24.3%) |
1-3 Days a week | 127(73%) | 36(64.3%) | 163(70.9%) |
Occasionally | 9(5.2%) | 2(3.1%) | 11(4.8%) |
Where do you get the khat for chewing | From my school friends | 14(8%) | 3(5.4%) | 17(7.4%) |
From khat store | 5(2.9%) | 4(7.1%) | 9(3.9%) |
From my family | 92(52.9) | 18(32.1%) | 110(47.8%) |
From khat Farm | 63(36.2%) | 31(55.4%) | 94(40.9%) |
When did you start khat chewing | 5-6 grade | 47(27%) | 12(21.4%) | 59(25.7%) |
Grade 7th | 83(47.7%) | 29(51.8%) | 112(48.7%) |
Grade 8th | 45(25.3%) | 15(26.8.7%) | 59(25.7%) |
First Age to start khat chewing | 10 yrs. or more less | 5(2.9%) | 0 | 5(2.2%) |
11-12years. Old | 43(24%) | 13(32.6%) | 56(24.4%) |
13-14 years. Old | 126(72.4%) | 43(76.7%) | 169 (73.4%) |
Common source of money to buy khat | Family | 114(65.5%) | 24(42.9%) | 138(60%) |
Friends | 4(2.3%) | 1(1.8%) | 5(2.2%) |
Relatives | 4(2.3%) | 3(5.4%) | 7(3%) |
My income | 9(5.2%) | 3(5.4%) | 12(5.2%) |
No, I can’t buy khat | 43(24.7%) | 25(44.6%) | 68(29.6%) |
Commonly with whom did you chew khat? | With my school friends | 163(93.7%) | 43(76.8%) | 206(89.6%) |
With my family | 3(1.7%) | 5(8.9%) | 8(3.5%) |
Alone | 8(4.6%) | 3(5.4%) | 11(4.8%) |
With my friends out of schools | 0 | 5(8.9%) | 5(2.2%) |
Where did you commonly chew khat? | At school | 1(0.6%) | 0 | 1(0.3%) |
At home | 61(35.1%) | 34(60.7%) | 95(41.3%) |
At Relative Home | 3(1.7%) | 2(3.6%) | 5(2.2%) |
At my friend’s home | 58(33.3%) | 13(23.2%) | 71(30.9%) |
At study house | 37(21.3) | 3(5.4%) | 40(17.4%) |
At others place | 14(8%) | 4(7.1%) | 18(7.8%) |
3.3. Factors Associated with Khat Chewing
The bivariate analysis revealed that sex, age, religion, school grade, ethnicity, family main source of income, residence, living with khat chewers, easy availability of khat, having family chew khat, having peers chew, and cigarette smoking were associated with khat chewing (<0.25). In the multivariate logistic regression analysis, of the ten independent variables that were significant in the bivariate analysis, only four variables were significantly associated with khat chewing. Compared with female students, male students had close to three times higher odds of chewing khat [AOR = 2.47; 95% CI: 1.61, 3.86]. Similarly, early adolescents living with khat chewers had 7.48 higher odds of chewing than did [AOR=7.48; 95% CI: 4.60, 12.16] students who did not live with khat chewers. Compared with those who chewed khat, peers who chewed khat had 3.67 higher odds of khat chewing [AOR = 3.67; 95% CI: 2.45-5.40] students who did not have a history of peers who chewed khat. Similarly, the khat chewing rate was 1.95 times higher among early adolescents who easily obtained khat around residential areas [AOR = 1.95; 95% (1.01--3.78)] than among those who did not get khat easily in nearby areas. Cigarette smoking was statistically significant in the binary (crude) analysis but not when adjusted for other variables in the final model (
Table 3).
Table 3. Bivariable and multivariate logistic regression analysis of factors associated with khat chewing among early adolescents in elementary school students in Haramaya District, Oromia, Ethiopia, 2023.
Variables | Current Khat chewers | COR | P Value | AOR | P value |
Yes N (%) | No N (%) | COR (95%CI) | | AOR (95%CI) |
Age (completed years) | |
10-12 | 8 | 24 | 1 | | 1 | |
13-14 | 222 | 338 | 1.97(0.87-4.46) | 0.10 | 0.72(0.27-1.90) | 0.50 |
Sex |
Male | 174 | 216 | 2.10(1.45-3.03) | 0.00 | 2.47(1.61-3.86)* | 0.00 |
Female | 56 | 146 | 1 | | 1 | |
Ethnicity |
Oromo | 223 | 341 | 1.96(0.82-4.29) | 0.13 | 0.98(0.31-3.10) | 0.62 |
Amhara | 7 | 21 | 1 | | 1 | |
School Grade |
Grade 7 | 125 | 226 | 1 | | 1 | |
Grade 8 | 105 | 136 | 1.39(0.98-1.95) | 0.05 | 1.33(0.88-2.01) | 0.15 |
household main Occupation |
Farmers | 172 | 256 | 1.84(0.91-3.60) | 0.08 | 2.07(0.91-4.46) | 0.06 |
Civil Servants | 12 | 33 | 1.48(0.71-2.90) | 0.30 | 1.13(0.49-2.59) | 0.76 |
Daily Laborer | 12 | 26 | 0.90(0.56-1.47) | 0.60 | 1.12(0.06-2.06) | 0.69 |
Merchants | 34 | 46 | 1 | | 1 | |
Religion |
Muslim | 221 | 335 | 2.22(0.99-4.99) | 0.05 | 0.78(0.28-2.11) | 0.62 |
Orthodox | 8 | 27 | 1 | | 1 | |
Peers pressure |
Yes | 152 | 114 | 4.31(3.02-6.12) | 0.00 | 3.55(2.30-5.49)* | 0.00 |
No | 78 | 248 | 1 | | 1 | |
Easily Availability of khat |
Yes | 212 | 254 | 4.96 (2.91-8.40) | 0.00 | 1.95 (1.01-3.78)* | 0.041 |
No | 18 | 107 | 1 | | 1 | |
Living with khat chewers |
Yes | 195 | 133 | 9.55(6.28-14.50) | 0.00 | 7.48(4.60—12.16)* | 0.00 |
No | 35 | 228 | 1 | | 1 | |
Cigarettes Smoking |
Yes | 51 | 38 | 2.42(1.53-3.84) | 0.00 | 1.35(0.76-2.38) | 0.30 |
No | 179 | 324 | 1 | | 1 | |
4. Discussion
This study aimed to determine the prevalence of khat chewing and its associated factors among early adolescents in elementary schools in Haramaya District, Eastern Ethiopia. Accordingly, this study revealed that the current prevalence of khat chewing among early adolescents in elementary school in Haramaya District was high (38.9%). Male sex, having peers chew khat, residential area availability of khat and living with khat chewers were the most significant predictors of current khat chewing among early adolescents in elementary school.
The results of this study were greater than those of studies conducted among 14-year-old primary school students in Kenya (27.5%)
| [30] | Njeru LK, Mwangi JG. Influence of Khat (Miraa) on primary school dropout among boys in Meru County, Kenya. 2013. |
[30]
, adolescents in intermediate schools in Jazan, Saudi Arabia (16.2%)
and Tanzania (19.1%)
| [32] | Mavura RA, Nyaki AY, Leyaro BJ, Mamseri R, George J, Ngocho JS, et al. Prevalence of substance use and associated factors among secondary school adolescents in Kilimanjaro region, northern Tanzania. PLoS one. 2022; 17(9): e0274102. https://doi.org/10.1371/journal.pone.0274102 |
[32]
. These findings are higher than those of studies carried out among school-aged adolescents in the Harari Region (20.4%);
| [18] | Birhanu A TB, Addis Eyeberu, Tamirat Getachew, Elias Yadeta, Abraham Negash, Magarsa Lami, Tegenu Balcha, Addisu Sertsu, Adera Deballa. Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. 2023. https://doi.org/10.2147/SAR.S401843 |
[18]
; Dire Dawa and Harar, Eastern Ethiopia, 24.2%
| [25] | Reda AA, Moges A, Biadgilign S, Wondmagegn BY. Prevalence and determinants of khat (Catha edulis) chewing among high school students in eastern Ethiopia: a cross-sectional study. PLoS one. 2012; 7(3): e33946. https://doi.org/10.1371/journal.pone.0033946 |
| [33] | Negussie B. Substance use among high school students in Dire Dawa, Ethiopia. Harar Bull Health Sci. 2012; 4: 38-42. |
[25, 33]
; North Shoa, 13.25% (34); Woreta school-aged adolescents, 13.8%
| [35] | Anteneh M, Birhanu, Telake Azale Bisetegn & Solomon, Meseret, Woldeyohannes High prevalence of substance use and associated factors among high school adolescents in Woreta Town, Northwest Ethiopia: multi-domain factor analysis. BMC Public Health. 2014. https://doi.org/10.1186/1471-2458-14-1186 |
[35]
; Bale, Southeast Ethiopia, 5.6%
| [36] | Dida N, Kassa Y, Sirak T, Zerga E, Dessalegn T. Substance use and associated factors among preparatory school students in Bale Zone, Oromia Regional State, Southeast Ethiopia. Harm reduction journal. 2014; 11(1): 1-6. https://doi.org/10.1186/1477-7517-11-21 |
[36]
; and Shakiso, Southwest Ethiopia,
| [37] | Gelchu BB. Substance Use and Associated Factors Among High School and Preparatory School Students of Shakiso Town. 2020. |
[37]
. legal status
| [38] | Radwa HaO. The Chewing of Khat: Saudi Arabia Addicted Drug La velle. Open Journal of Epidemiology. 2018. |
[38]
. Owing to variations in the study population, the timing, design, and setting differed from those of earlier studies conducted in various parts of Ethiopia, and the findings of the present study were greater. This conclusion is rationally justified because khat is easily accessible, affordable, and widely available in the study area because the local community depends economically on the cultivation of khat trees. Additionally, some Islamic believers use khat for their daily prayers, or "duway," although this practice is not mandated by religion. Furthermore, chewing khat was accepted as usual in the culture.
Numerous studies indicate that the early stages of adolescence, between the ages of 12 and 14, represent a crucial risk window for the onset of substance use
| [39] | SAMHSA. 2015 NATIONAL SURVEY ON DRUG USE AND HEALTH, Center for Behavioral Health Statistics and Quality. (2017). 2017; 1. |
[39]
. Owing to their accessibility and the strong influence of their classmates, many early adolescents begin taking khat in their early years. However, chewing khat contributes to poor academic performance and absenteeism in children of all levels, including high school pupils
| [40] | Mulugeta Y. Khat chewing and its associated factor among college students in Bahir Dar Town, Ethiopia. Science Journal of Public Health. 2013; 1(5): 209-14. |
[40]
.
In this study, male early adolescents had greater odds of chewing khat than female early adolescents did, which is in line with research findings from the Jazan Saudi Arabia
, the Harari region, eastern Ethiopia
| [18] | Birhanu A TB, Addis Eyeberu, Tamirat Getachew, Elias Yadeta, Abraham Negash, Magarsa Lami, Tegenu Balcha, Addisu Sertsu, Adera Deballa. Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. 2023. https://doi.org/10.2147/SAR.S401843 |
[18]
, and southwestern Ethiopia
| [37] | Gelchu BB. Substance Use and Associated Factors Among High School and Preparatory School Students of Shakiso Town. 2020. |
[37]
. This may be due to the greater sociocultural acceptance of male substance use in Ethiopia and other countries.
This study also revealed that peer pressure is strongly and positively significantly associated with khat chewing. This result was consistent with those of previous studies conducted in Harar senior secondary school adolescents
| [18] | Birhanu A TB, Addis Eyeberu, Tamirat Getachew, Elias Yadeta, Abraham Negash, Magarsa Lami, Tegenu Balcha, Addisu Sertsu, Adera Deballa. Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. 2023. https://doi.org/10.2147/SAR.S401843 |
[18]
, Axum school adolescents
| [42] | Gebreslassie M, Feleke A, Melese T. Psychoactive substances use and associated factors among Axum University students, Axum Town, North Ethiopia. BMC public health. 2013; 13(1): 1-9. https://doi.org/10.1186/1471-2458-13-693 |
[42]
and Hawassa South Ethiopia
| [43] | Kassa A, Wakgari N, Taddesse F. Determinants of alcohol use and khat chewing among Hawassa University students, Ethiopia: a cross sectional study. African health sciences. 2016; 16(3): 822-30. https://doi.org/10.4314/ahs.v16i3.24 |
[43]
. This may be because adolescents who chewers friends cope with their peer pressure.
This study revealed that the khat-chewing rate was 1.95 times greater among early adolescents who easily obtained khat availability around residential areas or near living areas. The findings of this study support the research results from Eastern Ethiopia
| [18] | Birhanu A TB, Addis Eyeberu, Tamirat Getachew, Elias Yadeta, Abraham Negash, Magarsa Lami, Tegenu Balcha, Addisu Sertsu, Adera Deballa. Nearly One-Fourth of Eastern Ethiopian Adolescents are Current Psychoactive Substance Users: A School-Based Cross-Sectional Study. 2023. https://doi.org/10.2147/SAR.S401843 |
[18]
and Eastern Ethiopia
| [22] | Zerihun E, Tesema K. Substance use and associated factors among Adolescents’ during the Covid-19 pandemic in Eastern Ethiopia: A cross-sectional study. medRxiv. 2022: 2022.03. 29.22273151. https://doi.org/10.1101/2022.03.29.22273151 |
[22]
. The possible reason might be that cultivation and consumption of khat are common in the study area, and in social and economic exchanges, the community views the harvest as a commodity to be used in competition with others. Because it grows locally, everyone, young and old, may obtain it for less or for free. This is why the relatively easy availability of khat appears to rank highest among the factors influencing the habits of early adolescents in their ability to chew khat.
The likelihood of early adolescents chewing khat was 7.48 times greater when they lived with khat chewers. This result is consistent with research from West China, Eastern Ethiopia
| [22] | Zerihun E, Tesema K. Substance use and associated factors among Adolescents’ during the Covid-19 pandemic in Eastern Ethiopia: A cross-sectional study. medRxiv. 2022: 2022.03. 29.22273151. https://doi.org/10.1101/2022.03.29.22273151 |
[22]
, Axium North Ethiopia
| [42] | Gebreslassie M, Feleke A, Melese T. Psychoactive substances use and associated factors among Axum University students, Axum Town, North Ethiopia. BMC public health. 2013; 13(1): 1-9. https://doi.org/10.1186/1471-2458-13-693 |
[42]
, and South Africa
| [44] | Hamdulay A, Mash R. The prevalence of substance use and its associations amongst students attending high school in Mitchells Plain, Cape Town. South African family practice. 2011; 53(1): 83-90. https://hdl.handle.net/10520/EJC80574 |
[44]
. As part low puts it, a person's actions speak louder than words about the treatment they receive from friends, family, peers, or surroundings
| [45] | Partelow S. Coevolving Ostrom’s social-ecological systems (SES) framework and sustainability science: four key co-benefits. Sustainability Science. 2016; 11: 399-410. https://doi.org/10.1007/s11625-015-0351-3 |
[45]
. Close family members' use of khat, such as parents and older siblings, was a significant risk factor for exposing early adolescents to khat and tobacco use. Examples of this included asking the child to join other family members in consuming khat, sending their children to buy khat or cigarettes on their behalf, and storing drugs in easily accessible places. Most early adolescents grow up in households where the parents either sell or chew khat as a means of subsistence. It was believed that early teenagers from these households had considerably easier access to khat and were more likely to view its usage as socially acceptable.
Early adolescents in this study started khat consumption at a young age. In the past, chewing khat was supposed to start at age 20, but nowadays, people in Eastern African nations start consuming the substance earlier. This is particularly true in eastern Ethiopia, where khat chewing among youth has become widespread
| [19] | Nigussie K, Negash A, Sertsu A, Mulugeta A, Tamire A, Kassa O, et al. Khat chewing and associated factors among public secondary school students in Harar town, Eastern Ethiopia: a multicenter cross-sectional study. Frontiers in Psychiatry. 2023; 14: 1198851. https://doi.org/10.3389/fpsyt.2023.1198851 |
[19]
. This could be as a result of the fact that socially acceptable use, growing, cultivation, and availability are prevalent in Eastern Ethiopia. However, early-onset substance use (such as khat, tobacco, and alcohol) is usually associated with negative health consequences.
According to Wondemagegn et al. (2017), this issue can be psychological, physical, interpersonal, social, educational, or legal
| [3] | Wondemagegn AT, Cheme MC, Kibret KT. Perceived psychological, economic, and social impact of khat chewing among adolescents and adults in Nekemte Town, East Welega Zone, West Ethiopia. BioMed research international. 2017; 2017. https://doi.org/10.1155/2017/7427892 |
[3]
. Drug usage can have detrimental impacts on one's health at any age, but teenagers who abuse drugs are especially vulnerable
| [46] | Goel MA. Costs, benefits, and cost-effectiveness of comprehensive drug abuse prevention. Washington, D. C: U.S. Government Printing Office. 2009. |
[46]
. This explains why students who self-reported having a problem with chewing khat had issues with sleep (21.6%), addiction (32.4%), and digestive system issues such as constipation, appetite loss, tooth damage (30.4%), and weight loss (9.5%). Furthermore, drug abusers have an increased chance of engaging in sexual activities that could lead to early or teenage pregnancy, contracting HIV, and contracting other STDs
| [44] | Hamdulay A, Mash R. The prevalence of substance use and its associations amongst students attending high school in Mitchells Plain, Cape Town. South African family practice. 2011; 53(1): 83-90. https://hdl.handle.net/10520/EJC80574 |
[44]
.
The primary justifications for khat chewing among early adolescents in the current study were availability 41 (12.1%), peer group influence 44 (19.5%), and study purpose 107 (46.5%). This study is comparable to that carried out in Eastern Ethiopia's. According to a survey, the most often cited motivation for chat chewing was to improve academic or work performance (73.3%), followed by peer pressure (24.3%) and the need to stay awake (51.5%). The primary motivation for beginning khat chewing (54.6%) was cited as being for study purposes, which was comparable to the lower percentage reported in prior research carried out at Jimma University. Socialization goals came in second (42.3%).
5. Limitations of the Study
The study's limitations prevented the measurement of important variables such as knowledge, attitudes toward benefits, perceptions, and associations with mental health conditions such as stress, anxiety, and depression. Determining whether there are any patterns among primary school pupils was challenging because of the dearth of local literature on the topic of conversation in relation to Hararghe. This cross-sectional study shows only the prevalence of khat chewing and is unable to draw cause‒effect associations between the studied variables. Moreover, as the study was conducted in a specific geographic area and among a particular demographic group, the findings may not be easily generalizable to other regions in Ethiopia or similar contexts.
6. Conclusions
Khat chewing is prevalent among elementary school early adolescent students in the study area. The factors most strongly associated with khat chewing were male sex, peer pressure, living with khat chewers, and the easy availability of khat, all of which are highly correlated with the use of khat by school-aged adolescents in eastern Ethiopia. This finding suggests that to reduce the negative impacts of khat use on one’s health, finances and social life, early intervention directed toward primary school and elementary school early adolescents is needed. Therefore, public awareness campaigns to inform adolescents and their parents are needed to reduce khat chewing among early adolescents. Moreover, the policy maker would better give due attention, and it is important to conduct a longitudinal study to investigate the causal relationship between khat use and its associated factors.
Abbreviations
AOR | Adjusted Odds Ratio |
CI | Confidence Interval |
CRC | Cluster Resource Center |
OR | Odds Ratio |
EDHS | Ethiopian Demographic Health Survey |
MOH | Ministry of Health |
ORHB | Oromia Regional Health Bureau |
SPSS | Statistical Package for Social Science |
WHO | World Health Organization |
Acknowledgments
The authors thank Haramaya University College of Health and Medical Sciences, School of Public Health, for the opportunities and support while this research was conducted.
Ethics Approval and Consent to Participate
The study was carried out under consideration of the Helsinki Declaration of medical research ethics. Ethical clearance was obtained from the institutional health research ethics review committee (IHRERC)/116/2022 of the College of Health and Medical Science, and a written permission letter was obtained from the Haramaya Woreda Education Office for each selected school's cooperation during the data collection period. All study participants' information was given about the study before the data were collected on its possible risk, benefit, confidentiality, privacy, voluntary activity, right to withdrawal, and time the questionnaire was taken, and then informed, voluntary, written, and signed consent was obtained from each participant’s parent or guardian before starting the data collection. Personal identification was written on the questionnaire, and all information that was obtained from them was kept confidential for the study participants. In the event that individuals are found to be addicted to khat chewing, their awareness of the disadvantages of khat chewing and other associated risk factors should be increased to change their attitudes toward khat chewing at all selected schools
Consent for Publication
Not applicable.
Trial Registration
Not applicable.
Author Contributions
Ibrahim Adem: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Tesfaye Gobena: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Tariku Dingate: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Dawit Abdi: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Kidist Mehari Azene: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Shimelis Tilahun: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Rudwan Yasin: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Olifan Getachew Wakjira: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Bethelhem Fekadeselassie Lemma: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Jerman Dereje: Conceptualization, Data curation, formal analysis, methodology, writing - original draft, writing - review & editing
Availability of Data and Materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Conflicts of Interest
The authors declared no conflicts of interest.
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APA Style
Adem, I., Gobena, T., Dingate, T., Abdi, D., Tilahun, S., et al. (2025). Khat Chewing and Associated Factors Among Elementary School Early Adolescent Students in Eastern Ethiopia: Multicenter Cross-sectional Study. Science Journal of Clinical Medicine, 14(3), 27-39. https://doi.org/10.11648/j.sjcm.20251403.11
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Adem, I.; Gobena, T.; Dingate, T.; Abdi, D.; Tilahun, S., et al. Khat Chewing and Associated Factors Among Elementary School Early Adolescent Students in Eastern Ethiopia: Multicenter Cross-sectional Study. Sci. J. Clin. Med. 2025, 14(3), 27-39. doi: 10.11648/j.sjcm.20251403.11
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AMA Style
Adem I, Gobena T, Dingate T, Abdi D, Tilahun S, et al. Khat Chewing and Associated Factors Among Elementary School Early Adolescent Students in Eastern Ethiopia: Multicenter Cross-sectional Study. Sci J Clin Med. 2025;14(3):27-39. doi: 10.11648/j.sjcm.20251403.11
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@article{10.11648/j.sjcm.20251403.11,
author = {Ibrahim Adem and Tesfaye Gobena and Tariku Dingate and Dawit Abdi and Shimelis Tilahun and Kidist Mehari Azene and Rudwan Yasin and Olifan Getachew and Bethelhem Fekadeselassie Lemma and Jerman Dereje},
title = {Khat Chewing and Associated Factors Among Elementary School Early Adolescent Students in Eastern Ethiopia: Multicenter Cross-sectional Study
},
journal = {Science Journal of Clinical Medicine},
volume = {14},
number = {3},
pages = {27-39},
doi = {10.11648/j.sjcm.20251403.11},
url = {https://doi.org/10.11648/j.sjcm.20251403.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20251403.11},
abstract = {Background: Khat chewing practices are common in the Arabian Peninsula and in Eastern Africa, including Ethiopia. Khat chewing is popular among adolescents in Ethiopia. However, there are no studies on the practice of Khat chewing among early adolescents in school children in the eastern part of the country, where the majority of khat in the country is produced and exported. Objective: This study aimed to assess khat chewing and associated factors among early adolescent school children in Haramaya district from September 1 to 30, 2023. Methods and Materials: A school-based cross-sectional study was conducted in Haramaya District from September 1 to 30, 2023. A total of 592 early adolescent school children were selected sampling technique with simple random sampling. Trained data collectors collected data structured questionnaires. The data were entered into EpiData version 4.6. The data were then exported to the SPSS version 23 statistical package for further data processing and analysis. Descriptive statistical tests and bivariate and multivariate logistic regression analyses were used to determine predictors of Khat chewing among early adolescents. The level of significance was set at a P value of less than 0.05. Results: The current prevalence of khat chewing was 38.9% (CI: 34.0%-42.1%). Among the studied variables, male sex [AOR=2.47; 95% CI: (1.61-3.86)], peer pressure [AOR=3.67; 95% CI: 2.45-5.40)], easy availability of khat [AOR=1.95; 95% (1.01-3.78)], and living with khat chewers [AOR=7.48; 95% CI: (4.60-12.16)] were significantly associated with current khat chewing practices. Conclusion: Khat chewing is prevalent among early adolescents in elementary school in the study area. The factors most strongly associated with khat chewing were male sex, peer pressure, living with khat chewers and easy availability of khat. The findings suggest the need to create public awareness among the community, particularly for adolescents and their parents.},
year = {2025}
}
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TY - JOUR
T1 - Khat Chewing and Associated Factors Among Elementary School Early Adolescent Students in Eastern Ethiopia: Multicenter Cross-sectional Study
AU - Ibrahim Adem
AU - Tesfaye Gobena
AU - Tariku Dingate
AU - Dawit Abdi
AU - Shimelis Tilahun
AU - Kidist Mehari Azene
AU - Rudwan Yasin
AU - Olifan Getachew
AU - Bethelhem Fekadeselassie Lemma
AU - Jerman Dereje
Y1 - 2025/07/14
PY - 2025
N1 - https://doi.org/10.11648/j.sjcm.20251403.11
DO - 10.11648/j.sjcm.20251403.11
T2 - Science Journal of Clinical Medicine
JF - Science Journal of Clinical Medicine
JO - Science Journal of Clinical Medicine
SP - 27
EP - 39
PB - Science Publishing Group
SN - 2327-2732
UR - https://doi.org/10.11648/j.sjcm.20251403.11
AB - Background: Khat chewing practices are common in the Arabian Peninsula and in Eastern Africa, including Ethiopia. Khat chewing is popular among adolescents in Ethiopia. However, there are no studies on the practice of Khat chewing among early adolescents in school children in the eastern part of the country, where the majority of khat in the country is produced and exported. Objective: This study aimed to assess khat chewing and associated factors among early adolescent school children in Haramaya district from September 1 to 30, 2023. Methods and Materials: A school-based cross-sectional study was conducted in Haramaya District from September 1 to 30, 2023. A total of 592 early adolescent school children were selected sampling technique with simple random sampling. Trained data collectors collected data structured questionnaires. The data were entered into EpiData version 4.6. The data were then exported to the SPSS version 23 statistical package for further data processing and analysis. Descriptive statistical tests and bivariate and multivariate logistic regression analyses were used to determine predictors of Khat chewing among early adolescents. The level of significance was set at a P value of less than 0.05. Results: The current prevalence of khat chewing was 38.9% (CI: 34.0%-42.1%). Among the studied variables, male sex [AOR=2.47; 95% CI: (1.61-3.86)], peer pressure [AOR=3.67; 95% CI: 2.45-5.40)], easy availability of khat [AOR=1.95; 95% (1.01-3.78)], and living with khat chewers [AOR=7.48; 95% CI: (4.60-12.16)] were significantly associated with current khat chewing practices. Conclusion: Khat chewing is prevalent among early adolescents in elementary school in the study area. The factors most strongly associated with khat chewing were male sex, peer pressure, living with khat chewers and easy availability of khat. The findings suggest the need to create public awareness among the community, particularly for adolescents and their parents.
VL - 14
IS - 3
ER -
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