An Investigation into Psychosocial Determinants of Khat use among Youth in Wote Town, Makueni County, Kenya

Abstract

Khat use is a growing public health concern among youth in Eastern Africa. This study investigated psychosocial determinants of khat use among youth aged 18-35 years in Wote Town, Makueni County, Kenya. The specific objective includes; to examine the sociodemographic characteristics of youth using khat in Wote Town, Makueni County, Kenya, to determine the prevalence of khat use among youth in Wote Town, Makueni County, Kenya, to evaluate the psychosocial factors influencing khat use among youth in Wote Town, Makueni County, Kenya, to examine the relationship between psychosocial factors and the sociodemographic characteristics of youth using khat in Wote Town, Makueni County, Kenya. Grounded in Problem Behavior Theory, Social Learning Theory, and Stress-Coping Theory, the research employed a cross-sectional descriptive design. Multi-stage sampling selected 179 participants from different geographical zones. Data collection utilized the WHO ASSIST tool, structured questionnaires, and key informant interviews with 12 stakeholders. Analysis included descriptive statistics, chi-square tests, correlation analysis, and thematic analysis. Findings revealed that 93.3% of participants demonstrated moderate to high-risk khat use patterns. The typical user profile included males (65.4%), older youth aged 26-35 years (69.8%), and economically vulnerable individuals (58.1% earning below 5,000 KES monthly). Early initiation was common, with 75.4% beginning use before age 21, peaking at ages 16-20 years (58.1%). Peer pressure (49.7%) and stress coping (48.6%) were primary initiation factors, while environmental accessibility received the highest agreement rating (M=3.94). Significant associations existed between demographic characteristics and khat risk levels, particularly educational background (χ²=39.652, p=0.000) and religious affiliation (χ²=36.965, p=0.000). Psychological distress showed the strongest correlation with khat risk levels (r=.51, p<.01), while income demonstrated protective effects (r=-.35, p<.01). The study concluded that khat use among youth represents a multifaceted phenomenon requiring comprehensive interventions addressing psychological, social, economic, and environmental determinants. Results inform evidence-based recommendations for prevention programs, policy development, and mental health services targeting youth populations in Kenya and Eastern Africa.