Addiction Nicotine Use The Inside of Cigarettes Bidi Cigarette Risks By Terry Martin Terry Martin Facebook Twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial process Updated on October 13, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print National Cancer Institute As of Dec. 20, 2019, the new legal age limit is 21 years old for purchasing cigarettes, cigars, or any other tobacco products in the U.S. Bidis (pronounced bee-dees and also known as beedis) are small hand-rolled cigarettes made of tobacco and wrapped in tendu or temburni leaf (Diospyros melanoxylon), a plant native to Asia. Bidis are manufactured in India and other southeast Asian countries and exported around the world. In India, bidi cigarettes are less expensive and more heavily consumed than traditional commercial cigarettes. It is a common misconception that because these cigarettes are less expensive, they are also less harmful. That is untrue. Bidis are as harmful as other cigarettes and can cause death from lung and heart disease. This article discusses what bidis are, how they are made, and their potential health risks. What Are Bidi Cigarettes? Bidis are sometimes referred to as "cigarettes with training wheels" by health authorities. Like clove cigarettes, the overall appearance and taste of this product are especially appealing to young people. They are typically tied on one or both ends with bits of colorful string and produced in a variety of flavors that appeal to kids, including chocolate, mango, vanilla, lemon-lime, mint, pineapple, and cherry. Bidi cigarettes gained popularity in the United States in the mid-1990s. Young American smokers were attracted to bidis because they were easier to obtain than traditional cigarettes, provided a rush of nicotine, and were small, flavored, and looked like marijuana joints. Bidi cigarettes are not associated with the Bidi brand of disposable vape products. Regulation By 1999, there was a call to action against bidis by state attorneys general. These officials urged Congress and federal authorities to stop their import to the U.S. Bidi consumption significantly declined in February of 2014 when the Food and Drug Administration (FDA) ordered four brands of bidi cigarettes be removed from the market: Sutra Bidis, Sutra Bidis Red, Sutra Bidis Menthol, and Sutra Bidis Red Cone. The manufacturer was unable (or unwilling) to provide documentation that proved the products do not raise new or different health concerns for the general public. This was the first tobacco ban put in place as a result of the Family Smoking Prevention and Tobacco Control Act that gave the FDA the authority to regulate tobacco products was in the United States. Bidis can still be purchased online, but have lost popularity in the United States since the ban. Health Risks of Bidis In some respects, bidis are actually more harmful than regular commercial cigarettes produced in the U.S. Bidi cigarettes contain three to five times more nicotine than traditional cigarettes, which means that there is an increased risk of nicotine addiction. Bidi cigarettes contain more tar and carbon monoxide than regular cigarettes. People who smoke bidis breathe in higher levels of toxins because bidis don't have chemicals added to help with combustion. People must draw on a bidi cigarette more often and with more force to keep it from going out. People who smoke bidis have an increased risk of oral cancer, lung cancer, stomach cancer, and esophageal cancer. The risk of heart disease and heart attack is three times higher for bidi smokers than nonsmokers. Bidi smoking is also associated with emphysema and increases the risk of chronic bronchitis. A Word From Verywell Bidi cigarettes are hazardous to human health and should not be considered a safe alternative to traditional cigarettes. Parents should proactively teach their children early on about the dangers of bidi cigarettes and smoking in general. Frequently Asked Questions How much nicotine does a bidi contain? Research has found that bidi cigarettes contain approximately 21.2 mg/g of nicotine, which is significantly more than the 16.3 mg/g of nicotine found in a regular filtered cigarette. Because of this increased amount of nicotine, it is also believed that people who smoke bidis are at a higher risk of becoming nicotine dependent. How are bidis made? Bidis are made in India and other countries in Southeast Asia. They are made by hand-rolling unprocessed tobacco in tendu or temburni leaves. They are then often tied using colorful strings. Are bidis illegal in the U.S.? You can still buy bidis online, but they have decreased in popularity since the FDA banned the sale or import of four bidi tobacco products. As of December 20, 2019, you must be 21 years old to purchase any tobacco products in the United States. 101 Healthy Alternatives to Smoking 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Duong M, Rangarajan S, Zhang X, et al. Effects of bidi smoking on all-cause mortality and cardiorespiratory outcomes in men from South Asia: An observational community-based substudy of the Prospective Urban Rural Epidemiology Study (Pure). The Lancet Global Health. 2017;5(2):e168-e176. doi:10.1016/S2214-109X(17)30004-9 Cision PR Newswire. Bidi Vapor receives FDA PMTA acceptance letter for all 11 Bidi Stick products. U.S. Food and Drug Administration. Family Smoking Prevention and Tobacco Control Act - an overview. Centers for Disease Control and Prevention (CDC). Bidis and kreteks. Singh S, Soumya M, Saini A, Mittal V, Singh UV, Singh V. Breath carbon monoxide levels in different forms of smoking. Indian J Chest Dis Allied Sci. 2011 Jan-Mar;53(1):25-8. PMID:21446221 Malson JL, Sims K, Murty R, Pickworth WB. Comparison of the nicotine content of tobacco used in bidis and conventional cigarettes. Tob Control. 2001;10(2):181-183. doi:10.1136/tc.10.2.181 American Cancer Society. Is any type of tobacco product safe?. Food and Drug Administration (FDA). Selling tobacco products in retail stores. By Terry Martin Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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