Research Paper Khat chewing and acculturation in East-African migrants living in Frankfurt am Main/Germany Stephan Bongard a,n , Motohiro Nakajima b , Mustafa al'Absi b a Dept. of Psychology Goethe-University Frankfurt, Theodor-W.-Adorno-Platz, PEG, 60323 Frankfurt am Main Germany. b University of Minnesota School of Medicine, Duluth, MN, USA article info Article history: Received 6 November 2014 Received in revised form 20 January 2015 Accepted 25 January 2015 Available online 3 February 2015 Keywords: Khat Cathinone Stress Migration Abuse Stimulant abstract Ethnopharmacological relevance: Khat (Catha edulis, Forsk) is a drug widely used in countries around the Red Sea (East-Africa and Arabian Peninsula). In Germany khat chewing is illegal but nevertheless an often observed habit in immigrants from this region. This study investigates the interrelation between immigrants acculturation processes and traditional khat chewing habits. Materials and Methods: Sixty-one khat chewers (14 female) from East-African countries were inter- viewed about their khat chewing habits and acculturation strategy using standardized questionnaires. Results: Results indicate that immigrants' khat chewing behaviors are similar to what is common in countries with traditional khat use. But khat chewing tended to be less among immigrants who were relatively more oriented towards their cultures of origin. Chewing khat was subjectively considered to help coping with problems, to forget bad memories and to concentrate better. Conclusions: It was concluded that khat chewing serves a functional use of coping with stressful events in the present or in the past within this sample. & 2015 Elsevier Ireland Ltd. All rights reserved. 1. Introduction When migrants come to a new country they bring their cultural habits with them. Some of those habits might be unknown, strange or exotic to the hosting society, some might even be in conflict with the norms of the receiving society, as is the case with khat chewing in Germany. Khat (Catha edulis Forsk) is an evergreen shrub that grows in East- Africa and the Arabian Peninsula (Al-Hebshi and Skaug, 2005) and is a member of the stafftree family (Calestraceae). Its leaves are harvested and consumed legally in these regions. Chewing the leaves of the khat shrub evokes a mild amphetamine like effect which can be attributed to the pharmacological potent phenylalkylamines—cathinone and cathine–which are also structurally related to amphetamines (Kalix, 1994). Cathinone is the more active ingredient of khat. It induces an increase in the activity of the dopaminergic pathways in the central nervous system (Kalix and Braenden, 1985) and an inhibition of noradrenalin uptake (Drake, 1988). The short term psychological effects of khat are characterized by feelings of optimism, elation, alertness, and general sense of euphoria and well-being (Cox and Rampes, 2003; Al-Hebshi and Skaug, 2005; Bongard et al., 2011a). Migration of people from countries with a tradition of khat chewing, mainly from Somalia, Ethiopia, Eritrea, Kenya and Yemen has brought this habit to Europe and North America where khat was widely unknown until the 1990s. In Germany, as in the majority of the countries of the EU, khat is regulated and chew- ing khat is illegal (see Griffiths et al., 2010). Recent bans were established in the Netherlands in 2012 and United Kingdom in 2013. However, banning the drug does not mean that the tradition of khat chewing vanishes in immigrant communities (Nencini et al., 1989; Stevenson et al., 1996; Griffiths et al., 1997). For example, a survey on khat chewing in Sweden revealed that 16% of a sample (n ¼ 206) of immigrants from Eritrea, Ethiopia and Somalia reported to be khat users. Within a Somali subsample the prevalence was 49% in this study (De Cal et al., 2009). Within a sample of 204 male Yemeni khat chewers living in London, UK, approximately one third of the khat users reported symptoms consistent with dependence syndrome (DSM IV; Kassim et al., 2013). Griffiths et al. (2010) concluded that, while there is a shortage of data on the use and patterns of khat use in Europe, khat chewing is limited to immigrant communities from countries where khat use is common. The aim of the present study therefore was to provide some insight into khat related behaviors in Germany. We attempted to describe khat consumption patterns of East-African migrants living in the city of Frankfurt am Main and to explore some factors that might affect this habit. Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jep Journal of Ethnopharmacology http://dx.doi.org/10.1016/j.jep.2015.01.034 0378-8741/& 2015 Elsevier Ireland Ltd. All rights reserved. n Corresponding author. Tel.: þ49 69 798 35321; fax: þ49 69 798 763 35321 E-mail address: bongard@psych.uni-frankfurt.de (S. Bongard). Journal of Ethnopharmacology 164 (2015) 223–228