SOCIO-ECONOMIC IMPLICATION OF KHAT CONSUMPTION ON THE HOUSEHOLD ECONOMY

This study applied exploratory-descriptive design, to determine the implication of Khat consumption on the household economy. The study was guided by both structural functionalism and conflict theories. The target population were families whose members consume Khat of which a sample of 350 respondents was obtained using snowball technique. Structured questionnaires were administered and analysed quantitatively and focus group discussions were thematically analyzed through narrative and verbatim. The study found that Khat consumption was widely accepted by all age groups and that the number of days Khat was consumed, the variety of Khat consumed, highest level of education attained by the consumer, employment status and income had negative effects on the household economy. There was a significant association between household economy and marital status (p = 0.006) as well as employment status (p < 0.0001). Khat regulation was preferred as well as community sensitization on the implication of Khat consumption.


Introduction
Since the beginning of time, all the documented societies have had mind altering drugs. These include stimulants and narcotics for drinking, smoking or chewing. The socio-cultural values and norms had what was acceptable and what was regulated. One of these mood and mind altering drug is Khat (Catha edulis). Khat is an ever green plant grown by grafting and cultivated as a bush or small trees [1]. It is a hardy crop which grows in arid areas up to ten meters tall under normal circumstances and grows up to five meters in non-equatorial regions. Khat has traditionally acquired cultural significance due to its association with traditional rites and customs such as marriage proposals, wedding celebrations, reconciliation processes and social gatherings, with group consumption predating the communal drinking of coffee in social contexts. Khat plant is mainly found in Ethiopia, Kenya, Somalia, Sudan, Madagascar, and South Africa and is also found in a lesser scale in Turkistan and Afghanistan [2]. While the medical implications of Khat consumption has been discussed to a fairly good extent, the socio-economic implications of its consumption has not been distinctly studied, particularly in communities with unique socioeconomic identities such as those living in urban areas in sub-Saharan Africa. Khat chewing has a deep rooted socio-cultural tradition, its pleasure inducing and stimulation effects seem to have a strong influence on the economy of the communities who indulge in it [3]. In Ethiopia, alcohol use after Khat chewing has also adversely affected the socio-economic and health status of consumers [4]. But in the paradox, Ethiopia is earning a lot of foreign income with a tradeoff of socioeconomic ills. In Ethiopia, 28.4 7 % of Khat producers earned an average annual income of about 500 USD per month, while 5.49 % of producers earned an average income of more than 3000 USD per year per household [4].
Since households are the main sector for the consumption in an economy, their activities are very much required to enhance economic development. Households also act as a saver of which their savings are considered as one of the main sources of capital formation in an economy. Thus the ban of Khat use in Europe, more especially Britain, has elicited mixed reactions among producers and consumers, with Britain claiming that the use of Khat is associated with family breakdown, mental health issues, socio-economic disadvantage and social disorder with special reference to Somali immigrants [5].

Structural Functionalism and Conflict Theories in Khat Consumption
Theories which have been put forward to explain substance abuse are found in diverse disciplines from genetic, neurobiology to Freudian psychoanalysis and Marxism. However, structuralfunctionalism and conflict theory offer a broader explanation based on immediate environment of family, household economy and social influences, particularly, during the vulnerable period of adolescence when risk-taking and sensational-seeking may be important impulses. Cultural and socio-economic factors are the key to understanding the conditions under which drug use is more likely to occur, the influence of formal and informal social controls and offer the most useful framework for analysis [6]. This study adopted both structural functionalism and conflict theories based on the assumption that household economy should be functional and stable. This stable system is characterized by household consensus, whereby the majority of the members show a common set of values, belief and behavioral expectation. According to this perspective, a household is composed of inter related parts each of which serves a function and contributes to the overall stability and solidarity of the society. Structural functionalism sees socio-economic structure and the organization of the society as more important than the individual [7].
The central idea of functional analysis is that; society is a whole unit that work together of which a household is viewed as a kind of living organism that must work together in harmony [7]. When all parts of society fail to fulfill their functions, the society is in a pathological state. Talcott Parsons  used the societal functions to refer to the beneficial consequences of peoples actions that help keep a group (society, family or social system) in equilibrium while dysfunctions are consequences that undermine the equilibrium of a system. The family and the household at large serves six essential functions namely economic production; socialization of children; care for the sick and aged; recreation; sexual control and reproduction of which if disturbed will course disintegration of the unit [8]. Since family life has various weakening issues to the ties that bind it together like financial matters, abdication of role playing and responsibilities reduce the family motivation to struggle together against hardships. The negative implications upon the family as a result of behavior change is what Merton referred to as latent function [9]. Khat consumption is not only limited to the consumer's body but the consumer's family and breaks down household ties when the head of the unit consumes it alone with the reality that Khat renders household economy bankrupt [10]. Khat is not only un-sensual commodity but also a serious entity that impacts on household budget and it is prevalently a male habit of which in Djibouti and Yemen male household head constitute the major consumers and are the key determinants of household economy [11]. The budget for house-hold head in Somalia had an adverse socio-economic bearing on the various needs of house-hold including education leading to household conflict hindering familial development [12]. The house-hold is harmed because of neglect, dissipation of the household income and inappropriate behavior by which in many cases lead to conflicts more especially where the spouse consumes Khat there exist the likelihood of separation or divorce due to neglect and irresponsibility towards essential requirement of the family [13].

Research Design and Data Analysis
This study applied exploratory and survey research design. Exploratory study design was found to be appropriate since there were very few earlier comprehensive studies to refer to. The study targeted the entire Khat consumers' households in Kamukunji constituency an urban settlement in Nairobi, the capital city of Kenya. The study also involved focused group discussions (FGD) made up of ward administrators, elders, religious leaders, women and youth representatives. This study applied purposive-snow ball sampling technique since there was no well-constructed sampling frame. The sample was distributed proportionately into the five wards of Kamukunji constituency. The ward with high population based on 2009 national census had a bigger portion in the sample of which Pumwani ward had 17 % of the population, Eastleigh North 20.41%, Eastleigh South 31.26%, Airbase 20. 36% and California 10. 24%. To explore the effects of Khat consumption on consumer household economy, the explanatory variables included; frequency of Khat consumption, duration of Khat consumption, type of Khat consumed and demographic profile of the Khat consumers. To measure household economy, the survey included questions on; management of household resources, work productivity, absenteeism from work, social relationship, nature of household ties, level of child nurturing and ability to manage household budget. Questions were on Likert scale of which responses were summed up and the average computed to obtain a score indicator of family household economy. Multiple linear regression analyses parameters were computed to establish the relationship between Khat consumption and consumer household economy. Qualitative data were analyzed through the process of coding where common themes were identified and examined in relation to the context, meaning and circumstances. Similarities and differences about the compiled codes were clustered together to create categories. Conceptual saturation was reached when no new category emerged. Theoretical memos were written throughout the coding process. Credibility of the data was established through persistent observation, peer briefing and number checks.

Descriptive Statistics
Out of the 350 questionnaires administered to the Khat consumers, 314 were returned. This translated to 89.7% response rate. 35.8 % of the respondents were females while 64.2 % were males. Thus Male Khat users had a strong identification with Khat use, while females were more ambivalent. This observation was supported by the focus group discussion which reported that: "Khat chewing is dominated by males of all ages in Kamukunji, they chew as they engage in discussions on business and other issues. When females are chewing Khat especially Muslims, they do it in secrecy to avoid exposure since it is against the prescribed moral values".
Those who were aged 41-50 were 10% and 2.8% were aged above 50 years. This indicated that majority (87.2 %) of the Khat consumers were aged between 21 and 50. This is the age when people are through with schooling and are empowered financially. In this age bracket, they are excited, exposed and would like to fit in the society. They stabilize at age 40 and the number of consumers' decline as they retire from active social participation and Khat consumption [14]. These results were in agreement with results from a study conducted in Ethiopia where adults in the age group 45-49 years were 3.6 times more likely to chew Khat as compared to persons of aged 15-19 years [15]. The main factor contributing to Khat consumption by the youth is the ease of availability [16]. In this study, 14.3% of Khat consumers were of age 10-20 which is regarded professionally as a worrying phenomenon since it may hamper the progress of the region's future generation. Most of the Khat consumers had their highest education level being secondary school (39.4%) followed by primary school's graduates (24.78%). Khat consumers with non-formal education were 8.66 % while 8.96% had university education. These findings were supported by qualitative results where the Focus group discussions reported that: spouse conflict and destabilization of the family unit. The divorced, separated and widowed had withdrawn from the society due to their previous marital experience. The highest percent of Khat consumers (37.91 %) were self-employed followed by 30.75% who were not employed. The least were students at 5.67% and temporary workers at 13.43%. The people who were permanently employed accounted for 12.24%. The highest percentage among not employed and self-employed can be explained due to freedom and time availability with minimal restriction which is associated with the self-employed and not employed persons. The unemployed were more likely to be using Khat than those employed [19].
23.3% of the Khat consumers earned less than 2,000 Kenya shillings per month while 23% earned more than 20,000. The survey reported that the number of Khat consumers were on average evenly distributed across the different income levels. As high income levels could have encouraged males to chew Khat, poverty related problems could also have contributed to the numbers with low income levels to chew Khat. Never the less, the results indicated that 42.1% of the respondent earn between Kenya shillings 5000 and 20000 revealing that the higher the income the higher the consumption of the Khat. For the lower age, this had some economic implication in that young people spent much of their income in Khat making them not to marry at early age. Furthermore, due to availability of different Khat variety at different prices the issue of earning more or less did not deter Khat consumers from purchasing. To assess the views towards Khat consumption, 51.6 % of the respondents had a positive view as compared to 47.2% who had a negative view These views were different from Focus group discussions who linked Khat with no benefits and would never recommend people to take but one Key informant reported that: "Khat is good for fun specifically to men but not for women due to family obligation" For the length of time the respondents had been consuming Khat, 52.2% had consumed Khat for less than 5 years followed with 28.7% who reported to have consumed Khat for between 6-10 years and 7.5% between 11-15 years. These results shows that as the number of years of Khat consumption increases the percentage of the consumers' decreased but those who had consumed for more than 20 years seemed to slightly increase. 22.4 % consumed alone. These results implied that most of the consumers were away from their families' longer hours and for those who consumed during the day time, they were not engaged in constructive occupation. This also implied that the negative health effects associated with Khat consumption is widespread in this area. These results cut across marital status implying the uniqueness associated with Khat consumption as a social phenomenon in this area. These results further implied that married Khat consumers are mostly away from their family since Khat consumption is done in dens in the evening and throughout the night. The focus group discussions reported that: The variety of Khat mostly consumed was Muguka (73.73%) followed by Kiza (18.21%) and the least consumed was Kangeta and others (8.06%). Muguka was preferred across the board regardless to the level of income. From the FGD,

"Muguka had higher stimulants and its impact was felt immediately compared to other varieties."
To assess the additives used together with Khat, 41.79% combined Khat with chewing gum, 32.84% consumed with peanuts, 13.73% used with cigarettes. The other additives used were bhang, sugar, coffee and beer. While the specifics of gum-as-diet-aid are still murky, white sugarsweetened gum is bad for the teeth but according to the American Dental Association, chewing sugarless gum stimulates saliva flow, which reduces plaque and helps prevent cavities [2]. Artificial sweeteners commonly found in chewing gum have adverse gastrointestinal symptoms, including diarrhea. While peanuts have healthy fats, there's still some saturated fat in them. Over consumption of peanuts increases blood phosphorus levels, causing bones to grow in the wrong places. Peanuts allergy causes side effects like hives and facial swelling. Smoking badly affects lungs leading to coughs, colds, wheezing and asthma. Smoking can also cause fatal diseases such as pneumonia, emphysema and lung cancer [2]. These results were supported by FGDs who said that: "All chewers use something, so apart from expenses from Khat there is an extra cost. It becomes also expensive to treat and manage the side effects related to Khat Consumption which include tooth decay and mouth swelling. Other additives used are ginger, candles wax, mosquitoes coil, and bhang" 51.04% of the respondents use additives as stimulants, 32.24% use additives as sweeteners and 15.82% use additives to add flavor. Stimulants increases activity in the central nervous system, they are pleasurable, invigorating and have sympathomimetic effects. Depending on the drug, stimulants can be smoked, ingested orally, snorted or injected. Stimulant effects can range from short-term energy boosts to long-term brain changes and (or) organ system injury. The harm may be long-lasting in extreme cases, but any amount of stimulant abuse can cause damage to the user. Stimulants leads to addiction especially when Khat consumers take it chronically for a prolonged period of time. Those who abuse Khat often take it for recreation purposes, to produce a feeling of calm, feel happier and talkative, as a weight loss agent that suppresses the appetite, to stay awake and improve alertness and to improve academic performance for students [2]. The FGDs cited the economic effects of Khat consumption on the individual and the family unit as: To test the null hypothesis that there is no difference between married status in terms of their likelihood of quitting Khat consumption versus the alternative hypothesis that there is a difference in married status and intention to quit consumption, the survey produced no evidence of any    Table 2.

Summary
In this study it was found that male Khat users had a strong identification with Khat use, while females were more ambivalent. The highest percentage of Khat consumers had at least secondary education and were self-employed. High income levels could have encouraged males to chew Khat. Most of the respondents who were Khat consumers believed that Khat consumption had more positive significance as compared to Focus group discussions who linked Khat with no benefits. Slightly more than half of the respondents had taken Khat for less than five years. Surprisingly, three quarters of Khat consumers interviewed had intention of quitting Khat consumption. Most of the Khat consumers in Kamukunji County consume Khat two days a week with most spending 5 to 10 hours per day consuming. Khat consumption is commonly done at night and in dens and partly in the streets with most of the consumers going home past 10 PM. Two thirds of the respondents considered themselves as moderate consumers compared to being heavy users. The survey produced no evidence of any difference in marital status in terms of their likelihood of quitting Khat consumption. Two-thirds of Khat consumers believed that Khat consumption can lead to addiction. Khat was consumed jointly with additives to act as stimulants, sweeteners and partly to add flavor. The commonly used additives were chewing gum, peanuts and cigarettes. The Survey response per gender reported that eight out of ten males preferred regulation as compared to 75% of the females who advocated for regulation while others preferred outlawing. Three out of ten Khat consumers surveyed earned between 2000-5000 Kenya shillings per month and those who earned above 20,000 were two in every ten consumers with the difference being significant. The study found a significant association between marital status and monthly income. The most preferred variety of Khat was Muguka which was accepted regardless to the consumers' level of income. The explanatory variables which had a negative effect on household economy were: number of hours spent on Khat per day, number of years one has been consuming Khat, gender, age and marital status. There was significant association between income and marital status and that Khat consumption in Kamukunji Constituency did not differentiate the consumers' level of income and marital status.

Conclusion and Recommendation
Khat has become the backbone of some region's economy, providing the main source of income for farmers, as well as jobs for thousands of others employed in the value chain. Households earn more income from Khat cultivation and trade, despite of public health concerns regarding Khat addiction and growing international pressure to ban its distribution. There is need for effective policies to better manage the production, consumption and trade of Khat, and to create an enabling policy and institutional support. The ecological and economic merits need to be weighed with the health and other social downsides. The need for careful and farsighted thinking need emphasis by all concerned. As the Khat -based household and regional economy is dependent on Khat, banning Khat consumption will have a devastating impact on the livelihoods of many in this region.
Since majority of the respondents chewed Khat to pass time, this study therefore recommends that, the county government should partner with the Ministry of Sports, Culture and Arts to develop more sporting and recreational activities to occupy the individual members more especially the youth. This would help individuals to realize and develop their talents through initiatives like music and drama, athletics and other sports, gyms and other religious social forums to enhance their physical psychological and social wellbeing. Secondly, most of the Khat consumers had relatively low levels of education, therefore the government through the Ministry of Education and County government to organize sensitization forums to create awareness on socio-economic implication of Khat among the family. Thirdly, most of the Khat consumers were found to have some level of ignorance, thus information on the dangers associated with consumption of Khat and other related substances to be passed to the general public by the concerned institutions. Fourthly, Non-governmental organizations should team up with financial institutions to provide financial support on the development of recreational facilities and Khat traders should be sensitize on the dangers of selling Khat to the under age. Finally, the Ministry of Health should partner with relevant stakeholders including; The National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) and social science professionals to strengthen the policy frameworks related to licensing of Khat trade, time to sell Khat, earliest age to start Khat consumption and cleanliness of Khat consuming dens. The county government should endeavor to regulate Khat consumption and trade rather than banning by providing license to all the Khat outlets since in turn they will end up getting tax revenue through established structures.