Seven in every ten khat chewers in Gondar City had an intention to stop khat chewing: cross-sectional study using Transtheoretical Model

BACKGROUND: Khat chewing practice is rapidly expanding worldwide and currently, an estimated over 10 million people chew khat daily. The transtheoretical model explains how behavior change occurs across the stages of change. So, this study aimed at assessing the intention to stop khat chewing and associated factors among khat chewers in Gondar City, northwest Ethiopia. METHODS: Community-based cross-sectional study was conducted from March to April 2019 in Gondar City, northwest Ethiopia. Six hundred five khat chewers participated in the study from six randomly selected kebeles. The data were collected using structured and interviewer-administered questionnaire. Bivariate and multiple logistic regression models were fitted. Adjusted Odds ratio (AOR) with 95% confidence interval (CI) and p-values less than 0.05 were used to declare a significant association. RESULTS: Of the study participants, 69.3% (95% CI: 65.8–72.9) had the intention to stop khat chewing within 6 months or before. The majority of the participants (55.4%) were at the contemplation stage. Higher self-reevaluation [AOR = 2.8, (95%CI: 1.6–5.0)], environmental reevaluation [AOR = 1.9, (95%CI: 1.1–3.3)] and social liberation [AOR = 1.8, (95% CI: 1.0–3.1)] were associated with intention to quit khat chewing. In addition, using additional substances daily, khat dependency, and early age initiation of khat chewing were associated with lower intention to quit khat chewing. CONCLUSION: The majority of the khat chewers had the intention to quit khat chewing. Increased self-reevaluation, environmental reevaluation, and social liberation process of changes were associated with enhanced intention of quitting khat chewing. Thus, stage-based interventions should be done to inspire khat chewers to realize their motivation of stopping khat chewing.