Concurrent use of khat and tobacco is associated with verbal learning and delayed recall deficits

Aims The present study assessed whether cigarette smokers who are also regular khat users would demonstrate greater impairments in verbal learning and recall compared to both non‐smokers who are khat users and control subjects. Design An independent‐measures, between‐subjects design with two covariates. Setting An out‐patient, university research center in T aiz, Y emen. Participants Subjects were 175 Y emeni college students (90 men, 85 women) ranging in age from 18 to 38 years. Seventy‐five subjects were self‐reported chronic cigarette smokers and khat users, 48 non‐smoking subjects were self‐reported to be chronic khat users and 52 non‐smoking subjects reported no current use or history of khat use. Measurements Verbal learning and verbal memory recall was assessed by subject performance on the A rabic version of the R ey A uditory V erbal L earning T est ( RAVLT ). Findings Statistically significant differences ( P  < 0.05) were observed in RAVLT acquisition learning trials 2–5 and on delayed recall measures between concurrent khat and cigarette users compared to both the khat‐only group and the control group of non‐users of khat and cigarettes. On each of these trials, concurrent users recalled fewer words, demonstrating a slowed rate of verbal learning. This same pattern of performance was also seen on delayed recall measures. Khat use alone did not affect immediate or delayed recall of previously learned words. Conclusions Khat users who smoke cigarettes have a lower rate of verbal learning and delayed recall of previously learned verbal material than khat users who do not smoke cigarettes. This may be due to pre‐existing differences between these groups of subjects.