Study focuses on khat chewing in Yemeni culture

The study, which is published online in the journal Substance Abuse, was done by BUSM class of 2013 students Paul Yi, John Kim and Khalil Hussein. Richard Saitz, MD, MPH, professor of medicine and epidemiology at BUSM and a physician specializing in addiction medicine at Boston Medical Center (BMC), is the paper's senior author.

Khat use is prevalent in Yemen as well as in parts of Africa and the Middle East. According to a 2008 study published in the Bulletin of the World Health Organization, approximately 90 percent of men and 73 percent of women in Yemen chew khat daily. The plant's active ingredient is cathinone, an amphetamine-like alkaloid with addictive properties that produces a pleasurable stimulant effect. Research has shown that khat usage plays a role in the development of cardiovascular, oral, hepatic, neurobehavioral and psychiatric illness.

To investigate the knowledge and attitudes about khat among medical students in Yemen, the researchers traveled to Yemen and conducted a survey of 62 students. A sub-group of those students then participated in a discussion-based seminar and a follow-up survey. While they demonstrated knowledge about the health effects of chewing khat and believed that it was unacceptable for health professionals to chew it, they did not believe that it is the health providers' role to ask about khat chewing habits, nor advise patients to stop chewing it.

In the paper, the researchers referenced a study published in 2011 by BMC Public Health (Biomed Central) that showed the majority of medical students in more than 48 countries agree that health professionals serve as role models and that they should advise patients to quit smoking cigarettes. "While these results are consistent with our results regarding the students' views of health professionals as role models, they are not consistent with the Yemeni students' attitudes about advising patients to quit chewing khat," said the authors.

Khat historically has played a major role in Yemeni culture and society, which may explain the Yemeni medical students' conflicting beliefs. The authors conclude that it may be important for Yemeni public health officials to make official statements about the potential harmful effects of chewing khat in order to encourage health professionals to get involved with their patients' chewing habits.

Provided by Boston University Medical Center