Khat Chewing as a Risk Factor of Cigarette Smoking in Ethiopia Systemic Review and Meta-Analysis

Background: Tobacco use is a major public health issue and strongest lifestyle related with increase probability of Cardiovascular Disease (CVDs), the objective of this systemic review and meta-analysis was to determine whether khat chewing is risk factor of cigarette smoking In Ethiopia. Methods: Eligible studies were identified by searching different databases like PubMed, Google Scholar and Web of science for published and unpublished articles; Data were extracted from the eligible studies using data abstraction form by two independent authors. Publication bias was assessed using the visual funnel plot and Egger’s test. Meta-analysis was performed by using random-effects models with the Der Simonian and Laird method. Results: Eight studies were found to be eligible and included in the meta–analysis. Out of 3839 respondents 751(19.56%) were cigarette smokers. The proportion of cigarettes smoking among khat chewers and non khat chewers were 40.43% and 11.54% respectively. The final pooled effect size after trim and fill was found to be 1.93 (95%CI: 1.71, 2.14). This showed the presence of a significant association between khat chewing and cigarettes smoking. Conclusions: Khat chewing were found to be significantly associated with cigarette smoking therefore, effective khat chewing prevention and intervention programs are required to reduce smoking among People in Ethiopia.