Puff and pass: How millions are smoking their way to the grave

“No cameras please, I don’t want my face to be seen anywhere. I’ll talk to you about it but if you start shooting, we’re done!” James (not his real name) warns, even as The Standard team settles for an interview with him about his smoking habit. We comply and fold our equipment. But James does not mind us taking notes.

James excuses himself almost immediately, shuffling into his slippers and walks to a man standing by the gate of his apartment block. After pleasantries, James is handed a fist-sized package, which he quickly pockets.

He comes back and invites us into his home in Athi River, where he works. He prefers to live here, away from his parents, who are not happy about his love for marijuana.

“There are two ways to get access to this herb, either as a bag of bud or a roll,” he says. He opens the package and places its contents on the table.

“This is a basic roll of marijuana from my supplier. They usually go for Sh50 per roll,” he says.

“It is always good to open the roll and roll it afresh, just to make sure you are not smoking any harmful things. This helps one to ensure the bhang is not laced with anything that may be harmful,” says James. “You also have to remove the sticks and stems so you don’t get a headache or anything of the sort.”

James goes ahead to tell Health & Science his story as he carefully extracts the chaff from the product, occasionally rubbing it between his thumb and index finger to ensure there are no any oddities.

“If it is good, the contents will stick together. As you prepare the roll, you get a feel of what you are about to smoke and the feeling you should expect,” says James.

He was 18-years-old when he first smoked marijuana. That was in 2008 and James was a secondary school student. The venue was a club in Westlands, Nairobi.

James says he was not immediately hooked to bhang, but continued to smoke once in a while. However, today, James smokes it at least three times a day.

“I have to take it in the morning, during the day and in the evening. It helps me  get a good night’s sleep,” he says.

“Weed is polite to the lungs. I also tried smoking cigarettes, but I coughed so much that I even started wheezing. Weed is not as heavy for the chest. If you get a good stash, it won’t be too strenuous, but if you get bush quality (low quality), it may not be friendly.”

James says the longest he has ever gone without smoking was a month. He, however, loves taking two-week breaks “to give the body time to breathe and let the lungs open up.”

“Also the more you smoke, the less intoxicated you get. If I stay for two weeks without smoking, it will just take one roll for me to get high the next time I smoke,” says James.

“I have never thought of quitting smoking; I don’t see the need to quit.”

While James doesn’t believe smoking marijuana makes one smarter, he says it “opens up the mind and boosts creativity”.

Robert Ndegwa, a throat cancer survivor, can only speak using an aid of an electrolarynx or a “throat back”, a medical device used to produce clearer speech by people who have lost their voice box, usually due to cancer of the larynx. Larynx is the hollow muscular organ forming an air passage to the lungs and holding the vocal cords.

“Were it not for the throat cancer, I would never have quit smoking. Tobacco is very addictive,” says the 65-year-old.

He says he smoked cigarettes for the first time when in Form One. He was 15.

In 2009, Ndegwa started working with the National Authority for the Campaign Against Alcohol and Drug Abuse to campaign against smoking. “Some people have told me they stopped smoking after they heard my story or read my book,” says Ndegwa.

He says people should stop using myths to justify smoking. “Avoid smoking like the plague it is. The consequences are dire. It is expensive and it leads to pain in the end,” says the throat cancer survivor.

There is plenty of information on the dangers of smoking, including warnings on cigarette packaging. However, this has not deterred smokers.

More than 8,100 Kenyans die from tobacco-related diseases annually, according to a report by the International Tobacco Control (ITC). The report, released by the Ministry of Health in May last year, also shows at least 220,000 children and 2,737,000 adults use tobacco daily.

From pipes and cigarettes to bongs and e-cigarettes, smoking has evolved. While smoking tobacco is the most common, some people have picked up other substances that have come with innovations. These include nicotine pouches, e-cigarettes and heat-not-burn tobacco. We also have marijuana, shisha and crack cocaine.

In 2020, the United Nations removed marijuana from its list of “most dangerous drugs”. The decision the United Nations Commission for Narcotic Drugs followed a recommendation from World Health Organisation, a decision that was expected to have a far-reaching impact on marijuana research and medical use in the world.

Prior to the vote, cannabis and cannabis resin had been listed alongside drugs such as heroin, methadone, morphine, opium and cocaine. But even after the decision, UN gave a disclaimer, placing marijuana among drugs that require high international vigilance.

And myths appear to be among the biggest impediments to the campaign against smoking. Some experts have trashed the myths terming them mere half-truths and dolled-up lies to make smoking look fashionable. For instance, there are those who believe smoking is harmless even after all the evidence it causes cancer among other health complications.

And the lyrics of a song by Jamaican dance hall singer Warren Gladstone Williams, popularly known as Future Fambo, appears to be promoting marijuana.

Medically speaking: Don’t believe the hype!

“All we do is puff puff pass, puff puff pass, rolling up the high-grade grass. Puff puff pass, puff puff pass, got to get it no matter the cost.”

A hit song it may have been, but doctors warn that as you bob your head to the beat, puff-puffing as it beckons, you may just be grooving your way to the grave.

But how exactly does this happen?

Dr Waweru Munyu, a Nairobi-based respiratory system specialist, explains: “There are about 4,000 different chemicals in one cigarette. Once in the lungs, they are absorbed into the bloodstream and distributed all over the body. They can cause inflammation of tissues. Excitation of the nerves leads to pleasure and addiction.”

“The tar gets onto the surface of the mouth and airway triggering certain reactions, including cancer.”

Smoking, which kills cells within the airway and lung tissue, is a major risk factor to noncommunicable illnesses such as diabetes, cardiovascular and respiratory diseases, among others.

It can also cause various cancers which can affect the mouth, throat, lungs, breast, prostate and even lead to stroke.

Chest specialist Joseph Aluoch says when lung immunity and breathing mechanisms are compromised, smokers are more susceptible to infections, including Covid-19. Smoking further exposes smokers to other chronic infections, he says.

“Nicotine is one of the most addictive substances. It plays on the pleasure centres of the brain,” says Munyu.

WHO says over 70 per cent of the 1.3 billion tobacco users in the world lack access to tools they need to successfully quit.

[email protected]