The world is witnessing a significant shift in tobacco and nicotine consumption, particularly among the youth. Electronic Nicotine Delivery Systems (ENDS) and Electronic Non-Nicotine Delivery Systems (ENNDS)—products like e-cigarettes, shisha, and nicotine pouches—have rapidly gained popularity in urban areas, leading to growing public health and regulatory challenges. These products are often marketed as safer alternatives to traditional smoking, yet mounting evidence increasingly suggests they pose serious health risks.

Globally, tobacco use remains a severe issue, contributing to an estimated 8.7 million deaths annually according to the World Health Organization (WHO). In Kenya, tobacco use still claims approximately 12,000 lives each year, according to the latest Ministry of Health data. Beyond the toll on public health, discarded cigarettes and nicotine pouches significantly damage the environment. Nicotine, the addictive substance in these products, perpetuates a cycle of addiction and leads to related health issues.

Since their introduction in 2006, ENDS and ENNDS have spread rapidly across Kenya, particularly among young people. A recent 2024 study by the National Taxpayers Association (NTA) shows that 7.3% of Kenyans now use these new-generation nicotine products, up from 5.6% in 2022. The survey highlighted stark regional variations, with wealthier areas such as Nairobi and Mombasa reporting higher usage rates compared to regions like Kisumu and Nyeri. The highest consumption rates were noted among men aged 26-35.

This trend is especially concerning as youth are particularly susceptible to nicotine addiction. According to South African Dr. Cyprian M. Mostert, a leading health expert at Aga Khan University, "The marketing of these products as safer alternatives is misleading. The health risks are real, and the youth, in particular, are being drawn into this cycle of addiction." His concerns echo a broader trend: the normalisation of smoking behaviours among young people.

In Asia, the trend of e-cigarette use among youth is particularly alarming in countries like China, India, and the Philippines. China, the world's largest producer of e-cigarettes, has reported a sharp increase in teenage vaping. Despite regulatory efforts, the country's youth vaping rate has risen to 5.6% in 2023, up from 3.3% in 2021, driven by the availability of flavoured products. India, despite its blanket ban on e-cigarettes in 2019, has seen a thriving illicit market that continues to supply these products to youth. In the Philippines, a recent WHO report noted a 6.2% prevalence of e-cigarette use among adolescents, which is posing serious concerns for public health advocates.

In Europe, countries like France and Germany have witnessed similar trends. In France, a 2023 national survey found that 13.5% of 18-25-year-olds regularly used e-cigarettes, with youth reporting easy access to flavoured products. Meanwhile, in Germany, the use of ENDS among young people increased by 4.8% in 2023 alone, despite stringent regulations on the sale and advertising of these products.

In the USA, where the use of ENDS is perhaps most prevalent, a 2024 CDC report found that 5.9% of middle and high school students were regular users of e-cigarettes. The popularity of flavoured products such as mint and fruit continues to be a key driver, despite efforts to ban such flavours in some states. The recent data highlights the influence of marketing strategies aimed at younger consumers.

A particularly troubling finding from the NTA survey is that 55.1% of users in less-resourced regions continue to consume illicit shisha, despite its government ban in 2017. This exemplifies the enforcement challenges Kenya faces. Dr. Cyprian emphasises the need for robust regulatory measures, stating, "The co-use of illicit cigarettes, cannabis, and ENDS/ENNDS, particularly in lower-income areas, poses a significant public health threat."

Kenya’s regulatory framework remains insufficient. Although excise taxes have been imposed on products like e-cigarette liquids and nicotine pouches, enforcement is inconsistent. Despite a USD 0.40 per milligram tax on e-cigarette liquids, illicit trade networks keep market prices lower than expected, undermining regulatory efforts.

Across Asia, Europe, and the USA, the tobacco industry employs a wide array of tactics to resist regulation. In India, tobacco companies have shifted focus toward other nicotine products, investing in corporate social responsibility (CSR) campaigns to enhance their image. In Europe, industry lobbying remains a key barrier to more stringent regulations on e-cigarettes and flavoured products. In the USA, large corporations use litigation to delay regulatory efforts and continue marketing their products.

Public health experts globally argue that products like e-cigarettes are deceptively promoted as safer alternatives, creating confusion among the public. As a result, comprehensive tobacco control efforts are weakened.

Taxation is among the most effective tools to curb tobacco and nicotine consumption. However, Kenya’s taxation framework faces significant hurdles. According to Dr. Cyprian, "The price of these products remains accessible even to school-going children." Furthermore, taxation inconsistencies between Kenya and neighbouring countries fuel cross-border smuggling, making it harder to control the illicit trade. International experts propose a unified tax system across East Africa, which could significantly reduce the smuggling of ENDS and traditional tobacco products.

The marketing of ENDS and ENNDS to youth is not unique to Kenya. A 2024 European Union report found that flavoured e-cigarettes continue to dominate the market, with 66% of young users preferring flavoured options. Similarly, in the USA, companies have targeted younger consumers with sleek designs and social media marketing, driving the rapid adoption of these products.

In Kenya, the NTA survey highlighted the need for more aggressive public health campaigns to educate youth about nicotine addiction. Thomas Lindi from the Kenya Tobacco Control Alliance (KETCA) asserts that the youth are especially vulnerable to the industry's tactics, saying, "Public education about the dangers of ENDS must be amplified to counter the industry's misleading marketing."

According to NTA CEO Irene Otieno, to tackle rising ENDS and ENNDS consumption, Kenya must adopt a multifaceted approach. This includes reforming the Tobacco Control Act, expanding public health campaigns, and increasing taxation to reflect the true health risks associated with these products. Harmonising taxation policies with neighbouring countries and strengthening enforcement will help curb cross-border smuggling.

Moreover, it’s vital to gather more data on ENDS consumption through collaboration between health practitioners, researchers, and international bodies. Targeted interventions informed by reliable data will address public health risks and socio-economic inequalities associated with these products. The world faces an evolving tobacco landscape, but with sustained efforts from public health advocates, policymakers, and civil society, the country can reduce nicotine addiction and protect the health of its most vulnerable citizens.