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Monitoring compliance with Kenya’s shisha ban in select public hospitality venues in Nairobi
  1. Simone Fukuda1,
  2. Salome Nyambura2,
  3. Joel Gitali3,
  4. Thomas Lindi3,
  5. Samson Otieno3,
  6. Alexandra Beem1,
  7. Bintou Camara Bityeki1,
  8. Maria G Carmona1,
  9. Ernesto Marcelo Sebrie1
  1. 1 International Research, Campaign for Tobacco-Free Kids, Washington, DC, USA
  2. 2 Department of Educational Foundations, Kenyatta University, Nairobi, Kenya
  3. 3 Kenya Tobacco Control Alliance, Nairobi, Kenya
  1. Correspondence to Dr Ernesto Marcelo Sebrie, Campaign for Tobacco-Free Kids, Washington, DC 20005, USA; esebrie{at}


Introduction Seven countries in the WHO African Region have banned the sale and/or use of shisha. In 2017, Kenya implemented a comprehensive ban on shisha, including the use, import, manufacture, sale, offer of sale, advertising, promotion, distribution and encouraging or facilitating its use. The objective of this study was to assess compliance with the ban of shisha use in select public hospitality venues in Nairobi, Kenya.

Methods Observational study that used a purposive sampling to select restaurants, bars and nightclubs where shisha use took place before the ban. A total of 200 venues were visited in seven areas of Nairobi City County, Kenya. Shisha use was defined as at least one person smoking shisha in any indoor or outdoor area of the venue accessible to the public, and indicators of shisha use as the display of any shisha equipment.

Results Overall, 81.5% of the venues visited were in compliance. Shisha smoking was observed in 16.5% of all venues and shisha equipment alone was observed in 2.0%. Among the different venue types, 94.6% of restaurants were compliant, 79.7% of bars and 75.6% of nightclubs.

Discussion The overall high compliance indicates that Kenya’s shisha ban is well implemented in Nairobi, and may be explained by the comprehensive nature of the shisha ban and the low prevalence in the general population. The variation in compliance may be due to the higher rates of use in university students and the additional resources required to enforce the ban in areas with high rates of crime.

  • low/middle income country
  • surveillance and monitoring
  • advocacy

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  • Contributors SF, NS, JG, TL, SOA and EMS conceptualised the study. NS, JG, TL and SOA coordinated the data collection. SF, AB, BC, MC and EMS prepared the first and subsequent drafts of the manuscript. NS, JG, TL and SOA contributed to revisions of the paper.

  • Funding This study was funded by Bloomberg Philanthropies and Bill and Melinda Gates Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.