{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:10:09Z","timestamp":1787317809293,"version":"build-2736575974"},"reference-count":57,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031116","name":"Bundes\u00e4rztekammer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031116","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ethnopharmacology"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.jep.2025.120639","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T07:35:20Z","timestamp":1758699320000},"page":"120639","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"PA","title":["EuroKhat: A pilot study on Khat consumption among Yemeni migrants in Germany"],"prefix":"10.1016","volume":"355","author":[{"given":"Abdullah","family":"Shabalah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Opel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3505-1575","authenticated-orcid":false,"given":"Alexander","family":"Refisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.jep.2025.120639_bib1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1002\/wps.20470","article-title":"Khat use and occurrence of psychotic symptoms in the general male population in Southwestern Ethiopia: evidence for sensitization by traumatic experiences","volume":"16","author":"Adorjan","year":"2017","journal-title":"World Psychiatry"},{"issue":"8","key":"10.1016\/j.jep.2025.120639_bib2","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/j.neubiorev.2010.03.006","article-title":"What are the cognitive effects of stimulant medications? Emphasis on adults with attention-deficit\/hyperactivity disorder (ADHD)","volume":"34","author":"Advokat","year":"2010","journal-title":"Neurosci. Biobehav. Rev."},{"issue":"6","key":"10.1016\/j.jep.2025.120639_bib3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0252900","article-title":"Khat and neurobehavioral functions: a systematic review","volume":"16","author":"Ahmed","year":"2021","journal-title":"PLoS One"},{"issue":"3","key":"10.1016\/j.jep.2025.120639_bib4","article-title":"Understanding khat: its sociocultural and health implications in Saudi Arabia","volume":"16","author":"Al Shubbar","year":"2024","journal-title":"Cureus"},{"issue":"2","key":"10.1016\/j.jep.2025.120639_bib5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5339\/qmj.2012.2.5","article-title":"Khat: a widely used drug of abuse in The Horn of Africa and the Arabian Peninsula: review of literature","volume":"2012","author":"Al-Juhaishi","year":"2012","journal-title":"Qatar Med. J."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib6","doi-asserted-by":"crossref","DOI":"10.1111\/jicd.12288","article-title":"Khat (Catha edulis) and its oral health effects: an updated review","volume":"9","author":"Al-Maweri","year":"2018","journal-title":"J. Investig. Clin. Dent."},{"issue":"10","key":"10.1016\/j.jep.2025.120639_bib7","doi-asserted-by":"crossref","first-page":"741","DOI":"10.2471\/BLT.08.011008","article-title":"Khat chewing in Yemen: turning over a new leaf","volume":"86","author":"Al-Mugahed","year":"2008","journal-title":"Bull. World Health Organ."},{"key":"10.1016\/j.jep.2025.120639_bib8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12991-020-00265-8","article-title":"Prevalence and risk factors for khat use among youth students in Ethiopia: systematic review and meta-analysis, 2018","volume":"19","author":"Alemu","year":"2020","journal-title":"Ann. Gen. Psychiatr."},{"issue":"4","key":"10.1016\/j.jep.2025.120639_bib9","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1080\/10826084.2019.1688350","article-title":"Knowledge and attitudes on khat use among Yemeni health sciences students","volume":"55","author":"Alshakka","year":"2020","journal-title":"Subst. Use Misuse"},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib10","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4103\/jfmpc.jfmpc_1254_21","article-title":"Risks of khat chewing on the cardiovascular, nervous, gastrointestinal, and genitourinary systems: a narrative review","volume":"11","author":"Alshoabi","year":"2022","journal-title":"J. Fam. Med. Prim. Care"},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib11","doi-asserted-by":"crossref","DOI":"10.5001\/omj.2023.46","article-title":"Adverse Effects of Chewing Khat (catha edulis): a Community-based study in Ethiopia","volume":"38","author":"Asfaw","year":"2023","journal-title":"Oman Med. J."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1186\/s12889-019-6495-9","article-title":"Epidemiology of khat (Catha edulis) consumption among university students: a meta-analysis","volume":"19","author":"Ayano","year":"2019","journal-title":"BMC Public Health"},{"issue":"19\u201320","key":"10.1016\/j.jep.2025.120639_bib13","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1007\/s00508-009-1259-7","article-title":"Khat - a controversial plant","volume":"121","author":"Balint","year":"2009","journal-title":"Wien. Klin. Wochenschr."},{"key":"10.1016\/j.jep.2025.120639_bib14","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jep.2015.01.034","article-title":"Khat chewing and acculturation in East-African migrants living in frankfurt am main\/Germany","volume":"164","author":"Bongard","year":"2015","journal-title":"J. Ethnopharmacol."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib15","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S0005-7967(96)00068-X","article-title":"Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples","volume":"35","author":"Brown","year":"1997","journal-title":"Behav. Res. Ther."},{"key":"10.1016\/j.jep.2025.120639_bib17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.drugpo.2016.02.009","article-title":"Legal harvest and illegal trade: trends, challenges, and options in khat production in Ethiopia","volume":"30","author":"Cochrane","year":"2016","journal-title":"Int. J. Drug Pol."},{"issue":"6","key":"10.1016\/j.jep.2025.120639_bib18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0020602","article-title":"Khat use is associated with impaired working memory and cognitive flexibility","volume":"6","author":"Colzato","year":"2011","journal-title":"PLoS One"},{"key":"10.1016\/j.jep.2025.120639_bib19","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1192\/bjp.128.3.280","article-title":"The SCL-90 and the MMPI: a step in the validation of a new self-report scale","volume":"128","author":"Derogatis","year":"1976","journal-title":"Br. J. Psychiatry"},{"issue":"7","key":"10.1016\/j.jep.2025.120639_bib21","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-061865","article-title":"Exploring the association between khat use and psychiatric symptoms: a systematic review","volume":"12","author":"Edwards","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib22","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13011-019-0208-3","article-title":"Impact of khat price increases on consumption behavior \u2013 price elasticity analysis","volume":"14","author":"El-Setouhy","year":"2019","journal-title":"Subst. Abuse Treat. Prev. Pol."},{"issue":"7","key":"10.1016\/j.jep.2025.120639_bib23","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1002\/ptr.5832","article-title":"Pharmacological and toxicological effects of Catha edulis F. (Khat)","volume":"31","author":"Engidawork","year":"2017","journal-title":"Phytother Res."},{"key":"10.1016\/j.jep.2025.120639_bib24","series-title":"Number of Foreigners in Germany by Nationality on December 31, 2023","year":"2024"},{"issue":"5","key":"10.1016\/j.jep.2025.120639_bib26","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.pnpbp.2007.12.033","article-title":"A review of the neuropharmacological properties of khat","volume":"32","author":"Feyissa","year":"2008","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"issue":"2","key":"10.1016\/j.jep.2025.120639_bib27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0263372","article-title":"A systematic review on risk factors for khat chewing among adolescents in the African continent and Arabian Peninsula","volume":"17","author":"Fiidow","year":"2022","journal-title":"PLoS One"},{"key":"10.1016\/j.jep.2025.120639_bib28","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.jep.2010.04.046","article-title":"Khat use and monitoring drug use in Europe: the current situation and issues for the future","volume":"132","author":"Griffiths","year":"2010","journal-title":"J. Ethnopharmacol."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib29","first-page":"1139","article-title":"Alcohol consumption and alcohol home delivery laws during the COVID-19 pandemic","volume":"43","author":"Grossman","year":"2022","journal-title":"Subst. Abuse"},{"issue":"Pt 2","key":"10.1016\/j.jep.2025.120639_bib30","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1348\/014466505X29657","article-title":"The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample","volume":"44","author":"Henry","year":"2005","journal-title":"Br. J. Clin. Psychol."},{"issue":"6","key":"10.1016\/j.jep.2025.120639_bib31","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/0164027504268574","article-title":"A short scale for measuring loneliness in large surveys: results from two population-based studies","volume":"26","author":"Hughes","year":"2004","journal-title":"Res. Aging"},{"issue":"10","key":"10.1016\/j.jep.2025.120639_bib32","doi-asserted-by":"crossref","first-page":"e1264","DOI":"10.4317\/jced.54163","article-title":"Is Khat (Catha edulis) chewing a risk factor for periodontal diseases? A systematic review","volume":"9","author":"Kalakonda","year":"2017","journal-title":"J. Clin. Exp. Dent."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib33","doi-asserted-by":"crossref","first-page":"175","DOI":"10.4314\/ahs.v17i1.22","article-title":"Prevalence of khat chewing and its effect on academic performance in sidama zone, Southern Ethiopia","volume":"17","author":"Kassa","year":"2017","journal-title":"Afr. Health Sci."},{"issue":"3","key":"10.1016\/j.jep.2025.120639_bib34","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.jep.2013.02.011","article-title":"Khat dependence syndrome: a cross sectional preliminary evaluation amongst UK-resident Yemeni khat chewers","volume":"146","author":"Kassim","year":"2013","journal-title":"J. Ethnopharmacol."},{"issue":"2","key":"10.1016\/j.jep.2025.120639_bib35","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1080\/15332640.2013.788908","article-title":"Khat: social habit or cultural burden? A survey and review","volume":"12","author":"Khatib","year":"2013","journal-title":"J. Ethn. Subst. Abuse"},{"key":"10.1016\/j.jep.2025.120639_bib36","series-title":"Forensic Chemistry of Substance Misuse: a Guide to Drug Control","author":"King","year":"2022"},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/02791072.2009.10400669","article-title":"Khat use: lifestyle or addiction?","volume":"41","author":"Manghi","year":"2009","journal-title":"J. Psychoact. Drugs"},{"key":"10.1016\/j.jep.2025.120639_bib38","series-title":"Handbook of Substance Misuse and Addictions: from Biology to Public Health","first-page":"1","article-title":"The use and abuse of synthetic cathinones (aka \u201cBath Salts\u201d)","author":"Manke","year":"2021"},{"key":"10.1016\/j.jep.2025.120639_bib39","doi-asserted-by":"crossref","first-page":"146","DOI":"10.2174\/1874192401711010146","article-title":"Khat (Catha Edulis) as a risk factor for cardiovascular disorders: systematic review and meta-analysis","volume":"11","author":"Mega","year":"2017","journal-title":"Open Cardiovasc. Med. J."},{"key":"10.1016\/j.jep.2025.120639_bib40","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/1462141","article-title":"Prevalence of common mental disorder and its association with khat chewing among Ethiopian college students: a systematic review and meta-analysis","volume":"2020","author":"Mekuriaw","year":"2020","journal-title":"Psychiatry J"},{"issue":"4","key":"10.1016\/j.jep.2025.120639_bib41","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1080\/09687637.2017.1338669","article-title":"Consequences of criminalisation: the Dutch khat market before and after the ban","volume":"24","author":"Nabben","year":"2017","journal-title":"Drugs Educ. Prev. Pol."},{"issue":"3","key":"10.1016\/j.jep.2025.120639_bib42","doi-asserted-by":"crossref","first-page":"161","DOI":"10.26719\/2017.23.3.161","article-title":"Level of khat dependence, use patterns, and psychosocial correlates in Yemen: a cross-sectional investigation","volume":"23","author":"Nakajima","year":"2017","journal-title":"East. Mediterr. Health J."},{"issue":"10","key":"10.1016\/j.jep.2025.120639_bib44","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0241056","article-title":"Lifetime prevalence of novel psychoactive substances use among adults in the USA: sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007-2014","volume":"15","author":"Neicun","year":"2020","journal-title":"PLoS One"},{"issue":"9566","key":"10.1016\/j.jep.2025.120639_bib45","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/S0140-6736(07)60464-4","article-title":"Development of a rational scale to assess the harm of drugs of potential misuse","volume":"369","author":"Nutt","year":"2007","journal-title":"Lancet"},{"issue":"9752","key":"10.1016\/j.jep.2025.120639_bib46","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1016\/S0140-6736(10)61462-6","article-title":"Drug harms in the UK: a multicriteria decision analysis","volume":"376","author":"Nutt","year":"2010","journal-title":"Lancet"},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib47","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1024\/2007.01.03","article-title":"Chronic khat use and psychotic disorders: a review of the literature and future prospects","volume":"53","author":"Odenwald","year":"2007","journal-title":"SUCHT"},{"key":"10.1016\/j.jep.2025.120639_bib48","series-title":"Khat Use in Europe: Implications for European Policy","author":"Odenwald","year":"2011"},{"issue":"10","key":"10.1016\/j.jep.2025.120639_bib49","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.3109\/10826089809069817","article-title":"Primary socialization theory: culture, ethnicity, and cultural identification. The links between culture and substance use. IV","volume":"33","author":"Oetting","year":"1998","journal-title":"Subst. Use Misuse"},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib50","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13011-023-00545-y","article-title":"Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base","volume":"18","author":"Olani","year":"2023","journal-title":"Subst. Abuse Treat. Prev. Pol."},{"key":"10.1016\/j.jep.2025.120639_bib51","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.euroneuro.2020.07.002","article-title":"How effective are pharmaceuticals for cognitive enhancement in healthy adults? A series of meta-analyses of cognitive performance during acute administration of modafinil, methylphenidate and D-amphetamine","volume":"38","author":"Roberts","year":"2020","journal-title":"Eur. Neuropsychopharmacol."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib52","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1477-7525-12-44","article-title":"Khat chewing and health related quality of life: cross-sectional study in Jazan region, Kingdom of Saudi Arabia","volume":"12","author":"Sheikh","year":"2014","journal-title":"Health Qual. Life Outcome"},{"issue":"2","key":"10.1016\/j.jep.2025.120639_bib53","doi-asserted-by":"crossref","DOI":"10.3390\/toxins14020071","article-title":"Khat, a cultural chewing drug: a toxicokinetic and toxicodynamic summary","volume":"14","author":"Silva","year":"2022","journal-title":"Toxins"},{"issue":"4","key":"10.1016\/j.jep.2025.120639_bib54","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/acer.14792","article-title":"Changes in alcohol use during the COVID-19 pandemic and previous pandemics: a systematic review","volume":"46","author":"Sohi","year":"2022","journal-title":"Alcohol Clin. Exp. Res."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib55","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13011-020-00268-4","article-title":"Khat induced psychotic disorder: case report","volume":"15","author":"Tesfaye","year":"2020","journal-title":"Subst. Abuse Treat. Prev. Pol."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib56","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00204-013-1163-9","article-title":"Khat and synthetic cathinones: a review","volume":"88","author":"Valente","year":"2014","journal-title":"Arch. Toxicol."},{"issue":"1","key":"10.1016\/j.jep.2025.120639_bib57","doi-asserted-by":"crossref","first-page":"61","DOI":"10.7326\/M20-1212","article-title":"Collision of the COVID-19 and addiction epidemics","volume":"173","author":"Volkow","year":"2020","journal-title":"Ann. Intern. Med."},{"issue":"3\u20134","key":"10.1016\/j.jep.2025.120639_bib58","first-page":"137","article-title":"Chemistry, pharmacology, and toxicology of khat (catha edulis forsk): a review","volume":"3","author":"Wabe","year":"2011","journal-title":"Addict Health"},{"issue":"2","key":"10.1016\/j.jep.2025.120639_bib59","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.socscimed.2007.04.038","article-title":"Khat use and mental illness: a critical review","volume":"65","author":"Warfa","year":"2007","journal-title":"Soc. Sci. Med."},{"key":"10.1016\/j.jep.2025.120639_bib60","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1186\/1471-2458-10-735","article-title":"Motives for khat use and abstinence in Yemen--a gender perspective","volume":"10","author":"Wedegaertner","year":"2010","journal-title":"BMC Public Health"},{"key":"10.1016\/j.jep.2025.120639_bib61","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3389\/fpubh.2014.00071","article-title":"Khat use, PTSD and psychotic symptoms among Somali refugees in Nairobi - a pilot study","volume":"2","author":"Widmann","year":"2014","journal-title":"Front. Public Health"}],"container-title":["Journal of Ethnopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0378874125013315?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0378874125013315?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:19:21Z","timestamp":1761697161000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0378874125013315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":57,"alternative-id":["S0378874125013315"],"URL":"https:\/\/doi.org\/10.1016\/j.jep.2025.120639","relation":{},"ISSN":["0378-8741"],"issn-type":[{"value":"0378-8741","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"EuroKhat: A pilot study on Khat consumption among Yemeni migrants in Germany","name":"articletitle","label":"Article Title"},{"value":"Journal of Ethnopharmacology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jep.2025.120639","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"120639"}}