Shisha smoking still popular in Nairobi night clubs

Three bourgeois-looking middle-aged men are seated at a local bar in Nairobi. They are drinking and smoking cigarettes in silence.

Veiled in the dark-bluish toxic fumes are female revellers, seemingly in their mid-twenties, sharing a shisha pipe as their hips sway to the music.

One of the girls, Sandra* reveals that she started smoking shisha when she joined university:

"I was 18 trying to hook up with a final year dude (man) and he invited me to try it for the first time. I smoked for what seemed like hours, and then passed out. When I go a day without smoking I feel irritable and discontent."

Hassan* has a similar story: "I was a freshman when I saw three guys with a weird looking pipe in the hood. I sat down to sample it and it was the strongest puff I had ever had. I have a friend who owes me money…I won’t go into detail but he is settling his debt through a shisha invite. I don't mind.’

Carol*, 28, also used to smoke shisha but decided to quit: "My thoughts were always foggy and I was uncomfortable with having to share a pipe with several people. The smoke from it is life threatening yet it can easily make you an addict. I am now trying to talk my friends out of smoking and sometimes I take them to see a counsellor."

Are young people slowly committing suicide by smoking shisha? Studies have established that shisha smokers inhale at a higher frequency and longer periods than usual cigarette smokers; the equivalent of 100 cigarettes or more in one indulgence.

Shisha smokers are often quick to defend themselves claiming that they do not inhale the smoke into their lungs but blow it out which makes it safe to smoke. However, according to a Harvard Journal, carcinogens from the smoke, whether inhaled into lungs or not, may contribute to lung cancer. Other toxins found in the pipe may lead to heart disease and respiratory problems.

According to Dr Paul Bundi Karau, tobacco causes lung cancer, cervical cancer and throat cancer. Apart from the addictive nicotine, tobacco has many other harsh chemicals such as hydrogen cyanide, lead, arsenic, ammonia, nitrosamines, formaldehyde, benzene and polycyclic aromatic hydrocarbons (PAHs).

He adds that tobacco is a risk factor for cardiovascular diseases because the chemicals in tobacco injure blood vessels.

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According to the Global Adult Tobacco survey of 2016, there are 3.1 million Kenyans exposed to exhaled tobacco smoke mainly from nightclubs and another 3 million from tobacco at home. About 2.1 million are exposed in restaurants. The unborn were not factored. This revelation highlights the challenge that faces Kenya in implementation of regulations on smoking tobacco in public places.

A 2014 study by the University of Florida says about 100 million people worldwide use hookahs daily. The same study says that cigarette sales are declining in many parts of the world, but shisha smoking is on the rise.

Shisha use is not only a growing public health threat that may lead to a rebirth of tobacco use among vulnerable populations and more health problems in general but it is also a time bomb that might cost the country arm and limb in terms of health expenditure.

Citing advice from WHO, Rwanda recently banned the product. "The use, advertisement and import of water-pipe tobacco smoking known as shisha tobacco is banned on Rwanda territory effective 15th December 2017," a statement from Dr Diane Gashumba, Rwanda's Health Minister reads in part.

The American Lung Association states that Shisha smoking needs greater intervention because it is “far from safe.” The association recommends regulations or laws or regulations on hookah smoking and labelling: "A comprehensive and all-inclusive strategy limiting availability of hookah use is fundamental to averting this deadly trend."