NEWS

Indian Cigarettes Gain Popularity, But Don't Let the Flavor Fool You

Nicole Gottlieb

The sugary bubble gum cigarettes that children once enjoyed have been replaced on many store counters with something that threatens far more than cavities. Bidis (pronounced "beedies"), the hand-rolled tobacco cigarettes imported from India and sold in tobacco, liquor, and convenience stores, and even in some health food stores, boast appealing flavors but daunting health risks.

Mango, strawberry, chocolate, cinnamon, and vanilla are only a handful of the flavorings that bidis offer to entice teens and young adults to these small cigarettes that resemble marijuana joints. Various studies have shown, however, that increased risks of heart disease and cancer are part and parcel of these flavorful smokes.

"We would expect the same 50 to 60 carcinogens found in regular cigarettes also to be found in bidis," said Donald Shopland, coordinator of the Smoking and Tobacco Control Program at the National Cancer Institute, Bethesda, Md. "The public should not consider them a safe alternative to cigarettes."

The U.S. Centers for Disease Control and Prevention in Atlanta recently published the nation's first official study on adolescent bidi use in its Sept. 17, 1999, issue of Morbidity and Mortality Weekly Report. The study of urban youth by the Massachusetts Department of Public Health's Tobacco Control Program supports the previous anecdotal reports and informal surveys that led public health officials to fear that bidi use was exceptionally high, particularly among young people.

Of the 642 adolescents surveyed, 40% in grades seven through 12 had smoked bidis at least once and 16% had smoked bidis in the past 30 days. The numbers were highest among Hispanic youth, but no statistically significant differences were seen in bidi use by race or ethnicity, sex, or school grade.

These figures were relatively low compared with the findings of a 1998 informal survey by the San Francisco Tobacco Free Project. High schoolers from Booker T. Washington Community Service Center surveyed 461 students at area schools and found that 58% of students had smoked a bidi in their lifetime and 31% smoked them on a regular basis.Go



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Youth advocates from the Booker T. Washington Community Service Center and the San Francisco Tobacco Free Project give a presentation on bidis. A survey conducted by the community service center revealed that 31% of high schoolers smoked bidis on a regular basis.

 
Disturbing Discrepancies

The Massachusetts study also asked why adolescents prefer bidis to cigarettes. About 18% of respondents said that it was because bidis were cheaper, 13% said they were safer, and 12% said that it was because they were easier to buy. Twenty-four percent of respondents cited taste as a factor in their choice of bidis over cigarettes.

Bidis are a form of cigarette and, by law, must bear the tax stamp and the rotating Surgeon General's tobacco warning and cannot be sold to people under age 18. The 1998 San Francisco survey, however, revealed a large discrepancy between what is required of bidis packaging and sales and what actually takes place.Go



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Although bidis are supposed to bear the Surgeon General's tobacco warning, like those pictured above, a 1998 San Francisco survey found that 70% of bidi packages lacked the warning.

 
Forty-one percent of bidis purchased lacked the tax stamp, helping to keep the price of bidis at around $2 or $3 per package of 20, almost half that of cigarettes; 70% of bidi packages lacked the required health warning about smoking; 24% of San Francisco stores surveyed sold bidis to underage youth.

The Booker T. Washington group filed a complaint with the Federal Trade Commission in 1998 addressing these violations. In May 1999, the community center, together with the Tobacco Free Project and the African-American Tobacco Free Project, called for the U.S. Customs Service to investigate the use of child labor in the production of bidis in India, and the subsequent legality of importing bidis to the United States.

Due to the "natural" look of bidis, which are made by wrapping tobacco flakes in a tendu or temburni leaf, tying them with a colored string and flavoring them, many people mistakenly think that they are safer to smoke than regular cigarettes. The omission of warning labels on packages further propels the myth of bidis' relative safety.

One bidi produces three times more carbon monoxide and nicotine and five times more tar than one regular cigarette, according to Samira Asthma, of the Office of Smoking and Health at the CDC. Because a bidi typically does not have a filter and the leaves used to wrap the tobacco are not porous, a smoker must inhale more often and more deeply to keep it lit. Studies in India have shown that this leads to larger amounts of tar, nicotine, and carbon monoxide in the lungs than when a regular cigarette is smoked.

No Surprise

The high rates of teen bidi use reported by the recent Massachusetts study were expected by some public health officials. "Even though it's high, I can't say that I'm surprised," said Cathy Backinger, Ph.D., of NCI's Tobacco Control Research Branch. "Adolescents like to try new things. Kids like to take risks. Some kids may also perceive that it's safer than cigarettes." The San Francisco teens said that bidis' resemblance to marijuana also contributes to their popularity.

Backinger stressed that bidis should not be dismissed as a passing phenomenon. "Spit tobacco was a fad in the 1980s and now it's a mainstay. We must include all forms of tobacco when talking about prevention and control — not just cigarettes."

Drug "Gateway"

The Massachusetts and San Francisco data have provided a window into regional teen bidi use, but public health officials point out that it is not clear how well the two studies represent national use, especially because both studies were not based on random samples.

The American Legacy Foundation in cooperation with the CDC Foundation is now conducting the first National Youth Tobacco Survey, which includes two questions on bidi use of youth in grades six through 12. The results are expected to be released in early 2000. One issue not addressed in the upcoming survey — but which researchers cite as important — is whether bidis are a "gateway" to other drugs.

While determination of national rates of bidi use remains in the future, many of bidis' health effects are already known. The cigarette might taste like a nutritious strawberry, but increased risks of coronary heart disease and cancers of the mouth, pharynx, lung, esophagus, stomach and liver are some of the consequences that smokers take on when they light up.



             
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