Sir, we enjoyed reading the recent paper concerning qat and its health effects (BDJ 2009; 260: 17–21). We have come across several patients originating from Somalia and Yemen, who are habitual qat users, purchasing the qat locally in Manchester. As the authors indicate, there is a lack of good quality evidence as to the long-term effects on oral health. The rise in qat use in the United Kingdom has been facilitated by the improvement of air transportation. The most active psychotropic constituent, cathinone, quickly breaks down within days to weaker psychoactive ingredients. Hence, the quicker the qat is chewed after picking, the more potent its effects.

At present, qat is predominantly used in the UK by immigrants from Southern Arabia and Eastern Africa. There is, however, some evidence of its wider use in the community. An investigation of recreational drug use in 'raves' in the Edinburgh area found the use of qat based products to be the second most popular drug taken after ecstasy.1 Whether the use of qat will become more widespread with time remains unclear.