Stopping khat use: Predictors of success in an unaided quit attempt

Introduction and Aims: Despite the adverse effects of khat use and chewers interest in cessation, there are few studies that have reported on the outcome of khat cessation attempts, and limited resources available for potential quitters. We used electronic diaries to monitor the outcomes of an unassisted quit attempt among daily and near daily khat consumers, and examine predictors of success.

Design and Methods: Sixty participants between the ages of 18 and 35 years who regularly chewed khat and who were attempting to quit were purposively recruited from an Ethiopian University campus. Real-time prospective daily recording of khat use was obtained for an average of 10 days prior to quit day (range 6–13) and 28 post-quit days (range 9–31), using an electronic diary.

Results: Almost all (95%) achieved initial abstinence. Of these, 80% reached at least seven continuous days of abstinence; 7% maintained continuous abstinence for 28 days post-quit. While 93% lapsed (average 11 days post-quit, SD = 7), only a smaller proportion relapsed (41%: chewed for at least three consecutive days after at least 5 days of abstinence). No demographic factors were predictive of successful abstinence.

Discussion and Conclusions: Regular khat chewers have difficulties in maintaining abstinence despite having motivation and desire to quit. This implies that treatment aids may be needed to assist chewers’ in their quit attempts. Controlled experimental trial through the use of available low cost quit aids and behavioural resources is crucial in order to increase success rates for those seeking to desist from khat use.