Bidi, a product of cottage industry, is the most prevalent form of tobacco smoked in India. A bidi contains crude tobacco wrapped in a dry Tendu leaf (Dyospyros melonaxylon). Health effects of bidi may therefore be different from those of cigarettes.
Smoking habits and respiratory symptoms were analyzed from the data collected as a part of a large multi-centric population survey conducted in/around four cities in India for studying the prevalence of asthma.
Preliminary analyses of data from 55,641 adult subjects (28363 men and 27278 women) revealed 16.4% prevalence of self reported smoking (30% men and 2.3% women). Amongst smokers 67.6% smoked bidis, 27.6% smoked cigarettes and 4.7% smoked hooka (traditional water pipe). Prevalence of common respiratory symptoms was higher in smokers than in non-smokers and in bidi than cigarette smokers. Multiple logistic regression modeling revealed higher OR’s for bidi smoking vis-à-vis cigarette smoking (Table 1Table 1:
Prevalence of respiratory symptoms in relation to different smoking habitsSymptom% Prevalence of the symptomLogistic Regression analysis with non- smokers as reference categoryNSCigarettesBidiHookaCigarettesBidiHookaOR*95%CIOR*95%CIOR*95%CIWheezing126.96.36.199.91.751.4-2.11.781.5-2.11.491.0-2.2Dyspnoea on exertion5.08.59.914.41.721.4-2.01.771.6-2.01.391.0-1.9Cough at night188.8.131.520.72.221.8-2.72.942.6-184.108.40.206-3.0Cough in morning220.127.116.111.22.552.1-3.02.812.4-3.22.391.7-3.4Phlegm in morning2.06.17.910.02.191.8-2.72.622.3-3.02.121.5-3.0Phlegm in morning >3 months/year18.104.22.168.31.911.5-2.42.942.5-3.42.461.7-3.6*
OR adjusted for age, sex, socio-economic status, atopy and family history of asthma. (NS = non-smokers)).
Bidi smoking highly prevalent in India and is associated with a high risk of respiratory symptoms that is even greater than cigarette or hooka smoking.
Tobacco cessation should be targeted at bidi smoking as much as cigarettes.
S.K. Jindal, None.