Khat (Catha edulis) is an herbal product consisting of the leaves and shoots of the Catha edulis Forsk shrub, a member (genera) of the evergreen celastracae family that is cultivated in most parts of the world, particularly in Eastern Africa and Arabia [1, 2]. It is also widely cultivated in Ethiopia [3]. Khat is chewed for its stimulatory effect due to the presence of more than 40 psychoactive substances contained in fresh leaves of the herb [4]. The dominant stimulator ingredients includes cathinone, cathine, and norephedrine [5]. These psychoactive substances stimulate chewers through the autonomic sympathetic nervous system, commonly called the ‘fight or flight’ response [6].
Studies have documented the number of khat chewers in Ethiopia has significantly increased over time, and now, it has become popular in all segments of the Ethiopian population [7]. Currently, it has become a significant practice in youth, especially university students, and quickly becoming a significant public health problem[8–10]. The prevalence of khat chewing was 27.7% among high school students in Dire Dawa [11], 6.7% among Adigrat University students[12], 28.7% among Axum University students [13], 23.6% among preparatory school students in Bale Zone [14], 33.1% among health officer and medical students of Jimma university [15], 40.0% among Adama university students[16], 24.2% high school students in Harare town [17], 37.8% among Jimma university students (29), 7.8% among Students at Debre Markos Poly Technique College[18], and7% among medical students of Addis Ababa University [19]. The major factors that influence khat chewing includes being male[14, 15, 17–20], being Muslim[15, 17], their age [15, 17], having friends who chewed khat [13, 17, 18, 20], Cigarette smoking [13], alcohol use[14, 19], similar habits by their family members [13, 14, 17, 20], year of study[15], pocket money[20], and others.
Students consumed khat to remain alert and wakeful at night, especially during examination periods. The detrimental personal and social effects of khat chewing are well understood. In addition to economic and social impacts, chronic use of khat is associated with increased blood pressure/hypertension [21, 22], development of gastrointestinal tract problems [22], cytotoxic effects on liver and kidneys [22–25], and keratotic lesions at the site of chewing [21], malnutrition, psychotic reactions after chronic use, depressive reactions, myocardial infraction and cardiovascular disorders [22, 26, 27], male sexual dysfunction [26], stroke and death [28]. Despite its health, social and economic impact; khat chewing becomes common practice among students and youths in Ethiopia. Khat chewing practices among university students, particularly those of medical students who spend a long time studying in universities, must be further studied. Therefore, the aim of this study was to assess the prevalence and associated factors of khat chewing among medical students enrolled at the University of Gondar in northwest Ethiopia.