Gaza City, the Gaza Strip – Next to a waste dump, a small informal market stretches along a dusty road in central Gaza City. Makeshift stalls line both sides, where vendors display large plastic bags of dried molokhia leaves alongside a few remaining packs of tobacco.

Molokhia - the leaves of the jute mallow plant - is typically used to make a thick stew. But at the stalls here it is used to make a "molokhia cigarette".

Alaa Jundiya has asked a vendor for one.

The seller takes a handful of dried leaves, crushes them between his fingers, and adds a small drop of liquid nicotine. The mixture is then rolled into thin paper and handed over.

The 27-year-old, who has been smoking for six years, describes how his habits were forcibly reshaped by war and soaring prices.

What was once a routine personal habit, Alaa says, is now another example of the high cost of living that now defines daily life in Gaza, with extreme inflation brought on by Israel's genocidal war now rampant.

“A [tobacco] cigarette now costs 100 shekels ($34)… it’s insane,” he says, exhaling smoke mixed with the distinct smell of molokhia.

“It doesn’t even resemble tobacco anymore… but it’s something we use because there are no other options.”

As a father of two, unemployed since losing his job as a carpenter at the start of the war, each pack of cigarettes has become an unaffordable burden.

“Before the war we tried everything… different types of tobacco, imported brands,” he says. “Now we’re smoking whatever we can dry and roll. It’s not a real alternative - it’s just a necessity.”

While there is no official confirmation from Gaza’s Ministry of Health, several doctors in respiratory and cardiac departments have reported cases of suffocation, breathing difficulties and facial discolouration linked to smoking molokhia cigarettes.

Dr Ahmed Saeed al-Jadba, a consultant ear, nose and throat specialist, warns that burning molokhia may be even more dangerous than traditional tobacco, and could increase the risk of cancer.

He explains that the substances added to dried molokhia include liquid nicotine, a known carcinogen, and in some cases even industrial substances such as pest-control agents or battery oils, making the mixture highly toxic.

“When these materials are burned, they release toxic gases like carbon monoxide and tar,” he says.

“These are the same harmful compounds found in traditional tobacco and are major causes of cancer and cellular damage over time.”

He adds that many patients arriving at clinics suffer from severe coughing, hoarseness, dark or yellow phlegm, and in some cases have been diagnosed with pre-cancerous lesions on the vocal cords.

Aljazeera