Adar Kahin held up a poster that warned, “Shisha may smell like fruit, but it is as dangerous as cigarettes.”

Kahin was standing at a clothing shop at the Karmel Mall in south Minneapolis, where two Somali American women sat by the counter, surrounded by brightly colored clothes. Neither of the women smoked, but Kahin and her cohorts were on a mission that afternoon: to spread the word about the dangers of smoking to the East African community.

Kahin’s group works for WellShare International, a nonprofit organization that goes into underserved communities to promote health and prevent disease. WellShare is now trying to curb smoking among Somali Americans through its East African Smoke-Free Program.

Health advocates are worried that smoking shisha, or hookah, has become too culturally accepted and that not enough people understand the health risks.

They also want to stop people from using electronic and regular cigarettes — the former have become more popular among Somali American youth, in line with their increased use in the overall population.

The program estimates that smoking prevalence for Somali American adults in Minnesota is 24%, much higher than that for adults overall.

“There are a lot of misconceptions in our community,” said Abdillahi Kahin, program manager at the Minneapolis office of WellShare International and Adar Kahin’s brother. “People believe that shisha is not as bad as cigarettes.” Shisha does, in fact, contain tobacco, sometimes flavored with fruit.

Health workers visit not just Somali malls, but also multiunit housing to educate Somali American residents about the dangers of secondhand smoke and to encourage them to talk to their landlords about establishing a smoke-free policy.

The group also works with East African businesses and mosques to encourage smoke-free rules. They try to raise awareness about the dangers of smoking at soccer tournaments and other neighborhood events, as well as at hair salons and henna shops. The organization partnered with five imams (prayer leaders at mosques) last year to broach the topic of tobacco during their Friday sermons.

They pass out fliers that say, “Tea and talk has long been a Somali tradition. Hookah and shisha have NOT.” They hand out stickers that say “Hookah is NOT part of Somali culture!” and display posters warning about the hazards of secondhand smoke.

“It’s bad … it can injure your lungs, your heart; it can alter your breathing,” said Fadumo Ali, 52, one of the women listening to Adar Kahin’s pitch at the clothing shop, Suhur Fashion.

WellShare community health worker Aisha Osman, who was working with Adar Kahin that day, noted that Somalis are often not allowed to drink alcohol due to Islamic prohibitions — which makes people turn to smoking.

“People want to socialize and get to know each other and do some fun [activities], so it’s more of a cultural thing nowadays,” said Osman.

Kahin and Osman are concerned that long nights of hookah-smoking can disrupt young men’s sleep schedules, causing them to stay up late and miss school.

At the Karmel Mall, Adar Kahin approached Yasir Askar, 32, who was ordering chicken shawarma.

“Almost everybody I know smokes,” Askar said, putting the figure at 80%.

“Eighty percent of men?” Kahin guessed.

Askar agreed that it was mostly men.

“It’s just part of their life,” said Askar. “It happens when they have free time. They just sit around as a group and smoke shisha … A lot of them know it’s not good for their health, but they just do it.”

As the group turned to leave, Askar shook hands with program coordinator Abdirahman Mahamud, saying, “Keep up the good work.”

At the next shop, Kahin and Osman encountered Amino Elmised, 49, who said fewer people would smoke hookah if it were less available.

“I would love for places that serve hookah to be shut down and every shop that sells these items to be closed,” said Elmised.

Dakaria Mohamed, 46, was smoking a cigarette near the entrance to the mall. He said he’s smoked nearly half his life, starting when he was in a refugee camp in Kenya in the 1990s. Sometimes he smokes shisha.

“I tried my best to quit,” he said. “I used the [nicotine] patch and gum and it didn’t work.”

But he was skeptical of the group being able to get people to stop.

“I know it’s dangerous — I know that,” he said. Mohamed also thinks that smoking is a waste of money. “There’s nothing you can help me with until I decide [to quit] myself,” he told Mahamud.

A man approached Mahamud to ask about the program, noting that he had a nicotine patch.

Abdi Farah, 21, said almost all the young people he knows smoke — weed, Juul (electronic cigarettes), and everything else. He doesn’t smoke, he said, because he’s on the Dakota County Technical College soccer team.

“Shisha is mostly for old people,” he said.

Back in the Minneapolis office off Franklin Avenue, Abdillahi Kahin is sympathetic to how hard it can be for people to simply stop smoking. He knows of a Somali American cabdriver who smokes to cope with the volatility of his job.

“He told me the reason why he was having a hard time quitting is because … one day the market is good, you pick up a lot of people, you’re happy, you drop people off, and then, later, it’s a really tough day and it makes you stressed that the market is not going really good for the day,” said Kahin.

“And then when you’re stressed, the best thing is to smoke.”

Many men in the community drive cabs, he noted.

“When I talk to them, I see many of them really understand the dangers of smoking, but … unless they get outside help,” Kahin said, “it may not be easy for them to just quit one day and walk away.”