Overview
What is Shisha?
Shisha is tobacco smoked through a water pipe. The tobacco is mixed with flavoured molasses (apple, mint, bubblegum, etc.) which makes the smoke taste pleasant and misleads many users into thinking it is less harmful than cigarettes.
Kenya banned shisha in 2017, becoming the fourth East African country to do so after Uganda, Tanzania, and Rwanda. The ban followed a Ministry of Health study that found 79.2% of shisha samples tested positive for heroin, and that certain flavours contained cannabis and cocaine.
Despite the ban, shisha remains widely available at nightclubs and private venues in Nairobi, Mombasa, and other cities. University studies at the Kenya coast confirm continued high prevalence, particularly among young adults.
What it does to the brain and body
How does it work?
Why people use it
What draws people to it?
The pleasant fruit flavours and social ritual of shisha make it popular in nightlife settings. It is perceived as safer and more sophisticated than cigarettes.
For many young Kenyans, shisha was an introduction to smoking. The flavouring masks the harshness of tobacco and reduces the psychological barrier to initiation.
The social ritual and extended session format make it a group activity with strong peer reinforcement.
Short-term effects
What happens when someone uses it?
These effects can occur even with first-time or occasional use.
- Nicotine effects: mild euphoria, relaxation, and dizziness
- Exposure to carbon monoxide (headache, nausea in high amounts)
- Relaxation in a social context
- Potential exposure to heroin, cannabis, or cocaine if adulterants are present
Long-term effects
What happens with regular or prolonged use?
- All the long-term harms of tobacco smoking, including lung cancer, COPD, and heart disease
- Risk of tuberculosis and hepatitis from shared mouthpieces
- Nicotine dependence
- In contaminated preparations, opioid or cannabis dependence
Recognising a problem
Signs that use may have become a problem
These signs apply to the person using the substance and can also help family members or friends recognise when help is needed.
- Attending shisha venues regularly despite the legal ban
- Craving nicotine between sessions
- Moving from shisha to cigarettes to satisfy nicotine needs
- Social activities becoming predominantly centred on shisha use
Addiction and dependence
How addictive is it?
The nicotine delivered through shisha is addictive at the same level as cigarettes. Regular shisha users develop nicotine dependence that may transition to cigarette smoking between sessions.
If adulterants such as heroin or cannabis are present, the addiction risk is significantly higher.
Overdose and acute danger
When does it become immediately dangerous?
- Carbon monoxide poisoning in poorly ventilated rooms: headache, dizziness, confusion
- If the preparation contains heroin: risk of opioid overdose, particularly in users with no opioid tolerance
- Seek fresh air immediately if you feel unwell during a shisha session
Withdrawal
What happens when someone tries to stop?
Who is most affected
Groups particularly at risk in Kenya
Young adults aged 18 to 30 in urban areas, particularly in Nairobi and coastal cities, are the primary shisha users.
University students, particularly on the Kenyan coast, show disproportionately high rates of shisha use in studies conducted after the 2017 ban.
In Kenya
What the data says about Kenya
Before the 2017 ban, shisha was widely available. A Ministry of Health and NACADA investigation found 79.2% of shisha samples positive for heroin. Nineteen specific flavours were found to contain bhang, heroin, and cocaine.
The 2017 ban has not eliminated shisha use. Research published in 2024 confirmed continued shisha use at coastal universities. Crackdowns by NACADA and County Health departments continue but enforcement is inconsistent.
The harm from shisha extends beyond nicotine: the potential for unknowingly consuming heroin or other drugs is a unique and serious danger specific to the Kenyan market.
Across East and Central Africa
How is it used in the wider region?
| Country | Local name(s) | Context and notes |
|---|---|---|
| Uganda | Hookah, Shisha | Banned. Uganda was among the first to ban shisha. Continued availability in Kampala nightlife reported. |
| Tanzania | Shisha, Malaisha | Banned. Continued availability in Dar es Salaam and Zanzibar tourist areas despite prohibition. |
| South Africa | Hubbly bubbly, Hookah | Legal and regulated as tobacco. Popular in South African nightlife. Significant youth use documented. |
| Nigeria | Hookah, Shisha | Significant use in Lagos and Abuja nightlife. Regulatory framework varies. |
Getting help
Where to turn in Kenya
NACADA Helpline
Free, confidential counselling and referral to treatment centres near you. Available 24 hours a day.
Mathari National Hospital
Kenya's main national psychiatric and substance use treatment facility in Nairobi. Inpatient and outpatient services.
County referral hospitals
Every county in Kenya has a mental health and substance use service. Ask at your nearest hospital or health centre.
Sources
References
- National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA). (n.d.). Shisha smoking could be conduit for hard drugs use by youth in Kenya. nacada.go.ke
- Allahdad, A. H., et al. (2024). Shisha Consumption and Presence of Cotinine in Saliva Samples among Students in Public Universities in Coastal Kenya. doi:10.1155/2024/5653709
- Ministry of Health, Kenya. (2017). Tobacco Control Act Amendment: Shisha Ban. Nairobi: Ministry of Health.
- National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA). (2022). National Survey on the Status of Drugs and Substance Use in Kenya 2022. Nairobi: NACADA.