By Elizabeth Merab

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Kenya has become the third country in East Africa to ban the smoking of water-pipe tobacco, popularly known as shisha, after Tanzania and Rwanda.

The ban contained in a legal notice dated December 28, prohibits the importation, manufacture, advertising, sale and use of shisha in commercial establishments such as restaurants and night clubs Kenya.

“No person shall import, manufacture, sell, offer for sale, use, advertise, promote, facilitate or encourage shisha smoking in Kenya,” reads the notice.

The prohibition is largely fuelled by health concerns and links with drug or alcohol abuse.

In the notice, Cabinet Secretary for Health, Dr Cleopa Mailu warned that anyone found contravening the rules on shisha smoking will be “liable to a fine not exceeding Ksh50,000 ($500), or to imprisonment for a term not exceeding six months, or to both.”

“If the offence, contravention or default is of a continuing nature, a further fine not exceeding Ksh1,000 ($10) for each day it continues will be imposed as contemplated in section 163 of the Public Health Act,” he added.

Dar, Kigali

Tanzania imposed a ban on shisha in July 2016, while Rwanda outlawed the practice through a public notice effective December 15, this year.

“Shisha smoking is damaging, addictive and dangerous on human lives,” the Rwandan government warned.

In a legal notice, Kenya’s Director of Medical Services Jackson Kioko said: “Our decision for the ban is informed by all aspects… from social to health and is also guided by scientific evidence of the negative impact of smoking shisha.”

Shisha smoking has become increasingly popular among young people and adults of both genders across East Africa.

But there have been growing concerns that smoking the fruit-scented tobacco through a bowl and tube is being used to cover up alcohol or drug abuse.

Occurrence of traces of narcotic drugs in the increasingly popular water-pipes (shisha) is a great cause for concern. This is because the exact ingredients used to make the shisha are often unknown due to poor labelling, and unstandardised manufacturing methods.

Research

In Kenya, a study done by the University of Nairobi notes that little is known about the composition of shisha consumed locally, making it prone to the possibility of adulteration with prohibited substances.

Researchers at the university tested eight samples of shisha products, and they all tested positive for drugs. They were laced with opiates (drugs derived from opium) and methamphetamines — a highly addictive stimulant that affects the central nervous system. It is used in the treatment of attention deficit hyperactivity disorder.

“The amphetamine test was negative for seven samples and positive for one sample,” reads the UoN report.

The study titled Traces of Opiates in Shisha Collected in Nairobi, Kenya notes that the occurrence of traces of narcotic drugs in the increasingly popular shisha are a great cause for concern.

The use of shisha has also been associated with health risks. For example, the study notes that since smoking is often social, and two or more people may share the same water-pipe, it exposes its users to infectious diseases such as TB and hepatitis.

The World Health Organisation (WHO) also notes that water-pipe smokers and second-hand smokers are exposed to the same health risks associated with cigarette smoking.

“Contrary to popular belief, the smoke that emerges from a water-pipe contains numerous toxicants known to cause diseases such as lung cancer, heart disease and respiratory disease,” the UN agency notes in its latest advisory note on water-pipe tobacco smoking.

Addictive

According to WHO, water-pipe tobacco smoking delivers the addictive drug nicotine, and, as is the case with other tobacco products, more frequent use is associated with the smokers being more likely to report that they are addicted.

A water-pipe smoking session may also expose the smoker to more smoke over a longer period of time than occurs when smoking a cigarette, according to the WHO.

“Reduced concentration of nicotine in water-pipe smoke may result in smokers inhaling higher amounts of smoke and thus exposing themselves to higher levels of cancer-causing chemicals and hazardous gases such as carbon monoxide than if one of the nicotine was absorbed by water,” notes WHO.

Cigarette smokers typically take eight to 12 cigarettes with 40 to 75 millimetre puffs over about five to seven minutes and inhale 0.5 to 0.6 litres of smoke.

In contrast, water-pipe smoking sessions typically last 20-80 minutes, during which a smoker may take 50-200 puffs which range from about 0.15 to one litre each, notes WHO.

The water-pipe smoker, the health agency argues, may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes.

Water-pipe origin

Although the origin of water-pipes is somewhat nebulous, it is known that trade routes through India and China helped disseminate the practice throughout parts of Asia, the Middle East and Africa.

Several epidemiological studies have indicated the growing use of water-pipes in all WHO regions and among young people and adults of both genders.

According to the Global Youth Tobacco Survey of tobacco use among 13–15-year-old children, the use of tobacco products other than cigarettes increased in 34 of 100 sites surveyed, which was largely attributed to rising water-pipe use.

Although empirical evidence is lacking and the origin of the water-pipe remains nebulous, anecdotal evidence for Algeria, Ethiopia, Kenya, Nigeria, Sudan, Uganda and Tanzania indicates a proliferation of fashionable hookah bars in the larger urban centres which are frequented mainly by the young and business people.