Severe respiratory impairment, significant cardio-respiratory conditions and follow-up mortality were found among bidi smokers as against cigarette smokers and non-smokers, said a study in "Lancet Global Health" journal.
The largest-ever prospective international community-based cohort study of its kind covered as many as 14,919 men across five centres in India, including Thiruvananthapuram besides one each in Bangladesh and Pakistan, a release said here.
"The health and economic burden caused due to bidi smoking are tremendous", said Dr Sanjeev Nair, from the Department of Pulmonary Medicine, Thiruvananthapuram Medical College, one of the co-authors of the study.
The other Indian centres covered in the sub-study of Prospective Urban Rural Epidemiology (PURE) were Chennai, Bengaluru, Chandigarh and Jaipur, it said.
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Households, with at least one member aged 35-70 years, were approached for the study, which was coordinated by the Population Health Research Institute in Canada.
Baseline data was collected from January 1, 2003, to December 30, 2009, and follow-up data collection took place from January 1, 2008, to December 30, 2013, it said.
Another co-author, Dr K Vijayakumar, secretary, Health Action by People, said the study had shown conclusively that there is no safe threshold from the harmful effects of smoking and even low-intensity, clinically-trivial smoking is associated with respiratory impairment.
Reaffirming existing information on the enormous impact of bidi smoking on the poor, the study found that heavy smokers were more likely to come from rural communities and from lower socio-economic sections.
Further, in what should be a worrying trend with a fast-aging population, the study pointed to a marked rise in decreased lung function among older bidi smokers, the release added.
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