Cannabis use is a reality in Kenya. Evidence-based harm reduction — not stigma — is how we protect health and human dignity. A comprehensive HRSK guide.
Cannabis is the most widely used illicit substance in Africa and the third most widely used psychoactive substance globally after alcohol and tobacco. In Kenya, cannabis — locally known as bhang — is classified as a narcotic under the Narcotic Drugs and Psychotropic Substances Act, yet its use is widespread across urban and rural communities alike.
The public health challenge is acute: prohibition has not eliminated cannabis use. Instead, it has driven use underground, prevented people from seeking help, and made it impossible to deliver evidence-based health information to those who need it. HRSK believes that a harm reduction approach to cannabis — one that does not require us to either endorse or ignore use — is essential.
Understanding Cannabis and Its Health Effects
Cannabis contains over 100 cannabinoids, with tetrahydrocannabinol (THC) being the primary psychoactive compound and cannabidiol (CBD) having well-documented therapeutic properties. The health effects of cannabis use depend on several key factors:
- Frequency of use: Occasional use carries far lower risk than daily or near-daily use.
- Age of initiation: Use that begins in adolescence is associated with greater risk of cognitive effects and dependency.
- Potency: Modern high-THC cannabis carries higher risks than lower-potency variants.
- Method of use: Smoked cannabis introduces many of the same combustion-related toxicants as tobacco. Vaporisation significantly reduces respiratory harm.
- Concurrent use: Cannabis combined with tobacco, alcohol, or other substances increases risk substantially.
Health Risks of Cannabis Use
Cannabis is not harmless. HRSK's commitment to evidence-based harm reduction means being honest about both the risks and the ways those risks can be reduced:
Mental Health
The most significant health concern associated with cannabis use is its relationship with mental health. Regular, heavy use — particularly of high-THC cannabis — is associated with:
- Increased risk of psychosis and schizophrenia spectrum disorders, particularly in those with genetic vulnerability
- Anxiety and panic attacks, especially with high-THC varieties or in inexperienced users
- Cannabis use disorder — affecting approximately 9% of all who try cannabis and up to 17% of those who start as adolescents
- Worsening of existing mental health conditions
Respiratory Health
Smoked cannabis shares many of the respiratory risks of tobacco. Regular cannabis smoking is associated with chronic bronchitis, increased respiratory infections, and long-term lung function impairment. Unlike tobacco, cannabis is typically smoked without a filter and the smoke is held in the lungs longer, increasing toxic exposure per puff.
Cognitive Effects
Heavy cannabis use — particularly when started in adolescence — is associated with measurable effects on memory, attention, and executive function. While many of these effects are reversible with cessation, some evidence suggests persistent effects in long-term heavy users.
Harm Reduction Strategies for Cannabis
HRSK advocates for the following evidence-based harm reduction approaches for cannabis:
- Delay initiation: The single most protective factor is delaying the age of first use. HRSK targets youth with clear, honest information about risk.
- Avoid mixing with tobacco: In Kenya, cannabis is commonly mixed with tobacco for smoking. This dramatically increases health risk from both substances.
- Use vaporisers instead of smoking: Vaporisation heats cannabis without combustion, significantly reducing respiratory harm.
- Avoid high-potency products: Lower THC content reduces the risk of acute and chronic mental health effects.
- Never drive after use: Cannabis impairs reaction time, attention, and judgement — road safety is a critical harm reduction message.
- Seek support for dependence: Cannabis use disorder is a real condition that responds well to brief interventions and counselling. Seeking help is not a moral failing — it is a health decision.
Kenya's Policy Context
Kenya's legal framework on cannabis is evolving. In recent years, there have been discussions about the potential licensing of hemp (low-THC cannabis) for industrial and agricultural purposes, while recreational cannabis remains illegal. Meanwhile, several African countries — including South Africa (personal use decriminalised), Zambia (medical cannabis licensed), and Lesotho (legal for export) — have moved towards more nuanced cannabis regulation.
Across Africa, the evidence is clear: blanket criminalisation of cannabis users has not reduced use and has instead created significant barriers to healthcare, added to the burden on the criminal justice system, and disproportionately impacted marginalised communities. HRSK does not advocate for recreational legalisation, but we do advocate for:
- Decriminalisation of personal use quantities to enable health-centred, rather than criminal justice-centred, responses
- Investment in evidence-based prevention and treatment services
- Open, honest public health information about cannabis risks — particularly for young people
- Regulation of any legal cannabis market that emphasises potency limits, youth access prevention, and consumer information
"We cannot protect people from harms we refuse to talk about. Honest, evidence-based education about cannabis is not the same as endorsing its use — it is a fundamental public health responsibility." — HRSK Research Team
Where to Seek Help
If you or someone you know is struggling with cannabis use, support is available. HRSK can provide information, referrals, and support. Brief interventions for cannabis use disorder are highly effective and widely available through healthcare providers across Kenya. Contact us at [email protected].
