Bidi smoking cost India Rs 80,550 crore in ill health and premature deaths

Bidi smoking cost India Rs 80,550 crore in ill health and premature deaths in 2017, accounting for around 0.5% of its GDP and 2.24% of its total health spend, according to research published in Tobacco Control, one of the scientific journals published by BMJ.

At least 72 million people over the age of 15 smoke bidis in India, accounting for 81% of the tobacco smoked, according to the Global Adult Tobacco Survey 2 (2016-2017) done by the Ministry of Health & Family Welfare and World Health Organisation.

Direct costs, which include consultation fee, diagnostic tests, medicines, hospitalisation and transport, make up just under 21% (Rs 16,870 crore ) of the total cost, with indirect costs of lodging and loss of income accounting for the rest.

The tax revenue generated from bidis was Rs 417 crore in 2016-17. “The economic costs of bidi smoking far outweigh any perceived benefits, both in terms of the employment generated or the taxes contributed. It’s consumption needs to be regulated using effective public health policies,” said study author, Rijo M John, senior fellow at the Centre for Public Policy Research in Kochi, Kerala.

Although a bidi is smaller and contains less tobacco than a cigarette, the nicotine content is significantly higher, said the study. And its relatively low burn point forces smokers to inhale more of the harmful chemicals, leading to several cancers, tuberculosis, lung diseases, heart disease and stroke, among others.

“Bidis are more dangerous than cigarettes and since the sector is unorganised, there is no quality control. There is nothing that tells us what is rolled inside the tendu leaf,” said Dr Pankaj Chaturvedi, head and neck cancer surgeon and deputy director at Tata Memorial Centre, Mumbai.

Taxation is the single most effective tool for regulating consumption of tobacco, according to the World Health Organization. “Along with increasing public funding on health to 2.5% of the GDP, Niti Aayog on Wednesday proposed greater tax on tobacco, alcohol and sugar-sweetened beverages. This study will add weight to the need for taxing all forms of tobacco, including bidis, to lower addiction,” said Dr K. Srinath Reddy, president, Public Health Foundation of India.

In India, bidis have historically been given a favourable tax treatment. “Cigarettes are taxed many times higher than bidis, which makes bidis cheap and leads to them outselling cigarettes by a ratio of 4:1. This needs to change and bidi taxes need to be increased many times more,” said John, who drew on several national and international data sources to estimate the direct and indirect costs of bidi smoking among 30-69-year-olds in 2017.

The employment generated by the industry does not outweigh the risks.“The employment offered by the bidi industry is seasonal and doesn’t lift those employed out of poverty line. It’s not gainful employment, it damages the health of workers and sometimes employs child labour. Increasing taxes and using the additional money to offer bidi workers alternative employment would bring huge economic and public health gains,” said Dr Reddy.

At least 63 million people are pushed into poverty in India because of expenditure on health. “About 15 million face poverty because of spending on tobacco and associated health costs, which also crowds out expenditure on food and education in India, especially among the poor,” said John.

The Tobacco Institute of India said it would not comment on the study and Umesh Parekh from the All India Bidi Industry Federation in Pune did not respond to phone calls and text messages seeking comment.