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Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education
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    Production of tobacco and prevention of tobacco use in India: two sides of the same coin?

    Mishra and colleagues1, discussed a fairly discouraging trend of smoking over decades in India. But in India, tobacco chewing is also associated with the risk of cancer among those who never smoked bidis or cigarettes.2 Smokeless tobacco products like Gutkha (crushed areca nut, tobacco) and pan masala (mixture of tobacco, essence and other ingredients) are available in attractive colorful small sachets for as low as half a rupee, and have become increasingly popular with aggressive marketing and advertisements.
    In addition, many Indians smoke the much cheaper, unfiltered crude tobacco product called Bidi, which is made of 0.15-0.25g of sun-dried flaked tobacco rolled in a dried rectangular piece of Tendu or Temburni leaf (Diospyrosmelanoxylon) and a thread securing the roll. Bidis have lower tobacco content than cigarettes, but more nicotine, tar and carbon monoxide. Stick for stick, they are deadlier. Unregulated, Bidi is a major form of tobacco use, with a predicted sale of 1031 billion bidis in 2007.3
    There are however two sides of the tobacco coin in India: One side allows for the production of tobacco in the country. In 2012, India was the 2nd largest producer of tobacco in the world.4 On the other side, there are increasing taxes on the sale of tobacco product, which is a way of generating revenue and restricting its use. Although it is thought that higher taxes would make cigarettes unaffordable to poor Indians, these taxes have had the effect of promoti...

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    Conflict of Interest:
    None declared.