The association between regular khat use and poverty in Ethiopia: a cross sectional study

Abstract Background: Khat use is widespread in Ethiopia and has increasingly raised economic concerns. Regular khat use may negatively affect productivity, household income, and social functioning. However, limited empirical research has examined its association with poverty. This study, therefore, aimed to examine the association between regular khat use and household food insecurity and wealth status in Ethiopia. Methods: A cross-sectional survey was conducted in the East Gurage Zone of the Central Ethiopia Regional State. 924 individuals randomly selected from the Addis Ababa University Health and Demographic Survey (HDS) registry participated in the study. Regular khat use was defined operationally as chewing khat 3 or more days per week in the past month. Household wealth status was assessed using wealth index indicators, while household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS). Univariate and multivariable logistic regression analyses were performed to examine the association of regular khat use with poverty-related outcomes (i.e. household food insecurity and wealth status), after adjusting for potential confounders. Results: The proportion of participants who regularly used khat was 57.3%. A higher proportion of regular khat users were classified in the low-wealth category than non-users (52.5% vs 34.9%). Household food insecurity was also higher among khat users than non-users (64.4% vs 35.6%). Regular khat use was significantly associated with low wealth status (AOR = 1.54; 95% CI: 1.11-2.13) and household food insecurity (AOR = 1.98, 95% CI: 1.39,2.83), after adjusting for potential confounders. Conclusion: We found that regular khat use was significantly associated with poverty-related outcomes, particularly household food insecurity. Overall, people who were classified as regular khat users were more likely to experience food insecurity and socioeconomic disadvantages than non-users. Our findings highlight the need for integrated interventions to reduce poverty and improve household food security through coordinated socioeconomic support and targeted strategies to curb regular khat use. Keywords: Khat use; Poverty; Wealth status; Food insecurity; Ethiopia