A transcultural pattern of drug use: Qat (khat) in the UK

National Addiction Centre, Maudsley Hospital, London.
The British Journal of Psychiatry (Impact Factor: 7.99). 04/1997; 170(3):281-4. DOI: 10.1192/bjp.170.3.281
Source: PubMed


This study investigates patterns of qat use among 207 Somalis living in London.
Subjects were recruited using privileged access interviewing. Somalian interviewers were recruited who shared the same culture as the subjects. Data were collected by means of a structured interview.
One hundred and sixty-two subjects (78%) had used qat. The majority (76%) used more qat than in Somalia. Some users reported moderate dependence; a minority reported severe problems. Adverse psychological effects included sleep problems, anxiety and depression. Medical problems associated with qat use were rare.
Qat users who continue to use this drug when it is transplanted from a traditional context may experience difficulties. Qat use can also be seen as playing a positive role in supporting the cultural identity of the Somalian community. Severe problems were rarely reported. Qat consumption should be considered when addressing health-related topics with patients from those communities in which qat use is common.

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Available from: Paul Griffiths, Oct 02, 2015
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    • "Recent bans were established in the Netherlands in 2012 and United Kingdom in 2013. However, banning the drug does not mean that the tradition of khat chewing vanishes in immigrant communities (Nencini et al., 1989; Stevenson et al., 1996; Griffiths et al., 1997). For example, a survey on khat chewing in Sweden revealed that 16% of a sample (n ¼206) of immigrants from Eritrea, Ethiopia and Somalia reported to be khat users. "
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    ABSTRACT: Khat (Catha edulis, Forsk) is a drug widely used in countries around the Red Sea (East-Africa and Arabian Peninsula). In Germany khat chewing is illegal but nevertheless an often observed habit in immigrants from this region. This study investigates the interrelation between immigrants acculturation processes and traditional khat chewing habits. Sixty-one khat chewers (14 female) from East-African countries were interviewed about their khat chewing habits and acculturation strategy using standardized questionnaires. Results indicate that immigrants' khat chewing behaviors are similar to what is common in countries with traditional khat use. But khat chewing tended to be less among immigrants who were relatively more oriented towards their cultures of origin. Chewing khat was subjectively considered to help coping with problems, to forget bad memories and to better concentrate. It was concluded that khat chewing serves a functional use of coping with stressful events in the present or in the past within this sample. Copyright © 2015. Published by Elsevier Ireland Ltd.
    Journal of Ethnopharmacology 02/2015; 164. DOI:10.1016/j.jep.2015.01.034 · 3.00 Impact Factor
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    • "A common complaint of khat chewers is constipation, probably caused by a combination of the astringent properties of the chemical in khat, called tannins and the sympathomimetic properties of cathinone [23]. Studies again reported about the effect of both khat and nicotine dependence on trouble experiencing mouth infection after khat chewing and oral cancer (squamous cell carcinoma) [24] [25] [26]. "
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    ABSTRACT: Khat is found in the evergreen tree or large shrub, consists of whole fresh leaves and buds of a plant known as Catha edulis. Bahir Dar is a city that three percent of Ethiopia’s total production of khat is originated from. There is no community based study that has been done in Bahir Dar city to determine effects of khat chewing behaviours on risk to elevated blood pressure. Therefore, this study aimed to assess effect of khat chewing on systolic and diastolic blood pressure. A community based cross-sectional study was conducted from January to September 2013among chewers of Bahir Dar city for determine effect of khat chewing on systolic and diastolic blood pressure. A structured questioner and medical measuring equipments were used to collect socio-demographic data, khat chewing behaviours and levels of physiological parameters. A total of 422 male khat chewers were included in study, 422 respond to the questioners, giving a response rate of 100%. The multivariate analysis result shown that the figure of having elevated systolic blood pressure among male chewers who chewed frequently was fourteen times more compared to who chewed less frequently (AOR:14.95,95%CI:5.49-40.66). The analysis result also revealed that those who spent more than 6 hours in a khat session were 7.25 times more likely to have elevated systolic blood pressure compared to those who spent less than 6 hours, (AOR :7.25; 95%CI: 4.03-13.05). It was also found that those who spent more than 6 hours in a khat session were almost 9 times more likely to have elevated diastolic blood pressure compared to those who spent less than 6 hours (AOR:8.99,95%CI:4.85-16.66). As for amount of khat chewed in the last 12 months, the risk of elevated systolic blood pressure was more than 5.26 times more likely among male chewers who reported increase amount of khat chewing compared to those who reported decrease the amount in the last 12 months, (AOR:5.26:95% CI: 2.76-10.15). Similarly, the risk of elevated diastolic blood pressure was more than 7 times more likely among male chewers who reported increase amount of khat chewing compared to those who reported decrease amount of khat chewing in last 12 months (AOR:7.25,95%CI:3.66-14.38). According to the study result explained above, it is possible to conclude that khat chewing behaviours have significant effect on blood pressure. Keywords Khat Chewing, Health Outcomes, Bahir Dar, North West Ethiopia
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    • "Some studies indicate that khat chewers increase their tobacco intake both overall and during khat chewing sessions [8,17,25], while others observed a compulsive need to smoke among naïve khat chewers who socialised with habitual smoker chewers and that current daily smokers may have initiated tobacco smoking due to khat chewing [32,33]. High percentages of both daily cigarette smoker khat chewers and STKU self-reported that smoking tobacco whilst chewing was important for enhancing the impacts of khat [25,34]. "
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    ABSTRACT: Background Chewing 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). Methods A 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. Results Of 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). Conclusions Khat 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.
    BMC Public Health 05/2014; 14(1):448. DOI:10.1186/1471-2458-14-448 · 2.26 Impact Factor
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