Intention to Catha edulis chewing cessation and associated factors among Catha edulis chewers of Bahir Dar University students, Northwest Ethiopia: Application of the Trans theoretical model

Over 10 million people chew Catha edulis worldwide. Evidence shows that the prevalence of Catha edulis chewing in Ethiopian university students ranged from 6.7% to 56.8%. This study was designed to assess the Catha edulis chewing cessation intention and its associated factors among university students. An institution-based cross-sectional study, using trans theoretical model, was conducted from November 1-30, 2022, among 419 Catha edulis chewers University students North West, Ethiopia. A stratified random sampling technique was used. A structured, pretested, and self-administered questionnaire was used to collect the data. Epi Data version 4.6 was used for data entry, and SPSS version 26 was used for analysis. Binary logistic regression analysis was performed. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) and p-values <0.05 in the multivariable model were used. Of the 419 study participants, 61.8% (95% CI, 55.8-67.8) of them had Catha edulis chewing cessation intentions within the next six months. Of these, one hundred forty-two (33.9%) were in the contemplation stage, and 117(27.9%) were in the preparation stage. High consciousness-raising [AOR = 4.58, (95% CI:2.43-8.66)], high self-reevaluation [AOR = 4.85 (95% CI:2.45-9.58)], high social liberation [AOR = 2.03, (95% CI:1.10-3.73)], positive decisional balance [AOR = 0.26, (95% CI:0.14- 0.47)], medium Catha edulis dependency [AOR = 0.25, (95% CI:0.07-0.84)], and high Catha edulis dependency [AOR = 0.35, (95% CI:0.19-0.63)] were significantly associated. The magnitude of Catha edulis chewing cessation intention was Low. High consciousness-raising, self-reevaluation, and social liberation were positively associated, while positive decisional balance and high Catha edulis dependency were negatively associated. Stage-based interventions should be implemented. Moreover, Programs targeted at increasing self-efficacy to combat chewing and preventive measures are needed by all stakeholders at different levels. Future research needs to look into the effects of khat on educational performance and quality of life among university students.