Khat Chewing Topography: An Exploratory Study of Its Constituents and Contextual Factors.

Introduction: Several studies reporting the association between khat chewing and health problems emphasized the role of "heavy use patterns." Such findings indicate the need to understand khat chewing topography, which is the mapping of the behavioral patterns regarding khat use and the contextual factors shaping such behaviors. The study of consumption topography offers the opportunity to examine the self-regulation systems individuals employ to maintain the desired physical and emotional state.

Methods: The study relied on a qualitative method in which 102 khat chewers were recruited from the general community in Jimma, Ethiopia using snowball sampling.

Results: Our findings reveal that khat chewing topography can be specified to the amount, the duration of a chewing session, the frequency, the rate, and the timing of chewing. The khat chewing topography is shaped through a complex interplay of multiple variables, which we categorized into six themes: perceived harms, the pre-chewing state, the khat variety, norms of khat chewing rate, the khat rhythm factor, and the context of chewing.

Conclusion: The typical behavioral pattern that this khat chewing topography identified indicates that khat chewers are not prisoners of the psychoactive compound found in khat. Instead, they regulate their chewing behavior by considering multiple factors, including the social norms of khat consumption and the possible harm to their health, social life, and personal budget. As a result, most of the chewers were able to build a consumption topography that helped them avoid risks associated with (excessive) chewing.