Brief intervention and mindset induction to reduce khat use among Ethiopian students – a randomized controlled trial

University students in Ethiopia often use the natural stimulant khat to boost academic performance. However, excessive khat consumption is related to mental and somatic problems and withdrawal symptoms, but interventions helping to reduce khat use are lacking. This randomized controlled study aimed to investigate the effectiveness of the standardized ASSIST-linked Brief Intervention (BI) in a pre-post design with a control group (CG). Additionally, we explored the effects of a mindset induction just before the intervention hypothesizing a boost effect on khat use outcomes. In a pre-registered randomized controlled trial, a sample of 322 university students from Jimma, Ethiopia, were randomly assigned (1) to the BI or cognitive tests as a control condition and (2) to either a deliberative or an implemental mindset induction. We used (generalized) linear mixed-effects models to test the effects of the BI and the mindset on khat use outcomes, controlling for covariates (e.g. comorbid psychopathology and motivation to stop khat use).The results revealed a general decrease in the amount and frequency of khat use in the two weeks after the intervention, with the BI group showing a significant greater reduction in frequency than CG. No significant effects emerged regarding the mindset induction. We found khat use affected by psychopathological symptom load and motivation to change khat use. The findings indicate that the adapted ASSIST-linked Brief Intervention can be promising in reducing khat use. More research is needed to enhance the effectiveness of khat-reducing brief interventions.