Bidi cigarette use among young adults in 15 states
Introduction
In the late 1990s, the public health community recognized a disturbing trend among young people—teenagers were experimenting with and using a tobacco product called bidis [1]. Manufactured primarily in India and other Southeast Asian countries, bidis are small brown hand-rolled cigarettes, consisting of tobacco flakes rolled in a tendu leaf, tied with a small string. They are enhanced with flavors such as cherry, chocolate, and vanilla almost exclusively for the US market. Like all other tobacco products, bidis are hazardous to one's health. The smoke from a bidi yields three to five times the amount of nicotine and tar as a regular cigarette [2], placing bidi users at risk for nicotine dependence [3] as well as at increased risk for throat, mouth, and lung cancers [4], [5].
Nationally, the reported use of bidis by youth nearly equals, and in some states, exceeds, rates of smokeless tobacco use [6]. There is a paucity of research on bidi use in the US and the few studies conducted have focused solely on adolescents [1], [6], [7], [8], [9], [10], [11]. While bidi use among youth is an important tobacco prevention and control issue, tobacco industry documents and publications suggest that the target market for bidis is actually young adults, most notably college students [12], [13]. For this reason, we sought to describe patterns and explore factors associated with bidi use among young adults, aged 18–24.
Section snippets
Methods
Surveillance on adult bidi use did not begin until 2001. We extracted self-reported data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS), a state-based random digit dial telephone survey of the adult population supported by the Centers for Disease Control and Prevention. The BRFSS collects data on health care utilization and risk behaviors from a representative sample of civilian non-institutionalized adults (≥ 18 years) in each of the 50 states. A detailed description of the
Results
Overall, among adults, 4.7% and 0.3% reported ever and current bidi use, respectively (see Table 1). Young adults, ages 18 to 24 years, reported the highest rates of ever (16.5%) and current bidi use (1.4%). Nearly two thirds of adults who reported current bidi use were under the age of 25. Among those young adults who reported current bidi use, almost all (99.4%) reported occasional or “some day” use. As shown in Table 2, there was considerable variation among the 15 states in the
Discussion
To our knowledge, this is the first paper examining bidi use among a US population other than adolescents. Based on data from the 15 states that added the optional tobacco module to their 2001 BRFSS, we found that 16.5% of young adults reported having ever used bidis, with state rates ranging from 6.0% to 30.3%. The rate of bidi use among young adults in 2001 slightly exceeded that of national prevalence estimates for adolescents in 2000, where 12.9% of high school students reported ever bidi
Acknowledgements
We thank Dorota Staniewska for her assistance on preliminary analyses, Spiro Yulis for his comments on an early version of this paper and state BRFSS coordinators. Completion of this work was financially supported in part through funding from an ASPH/Legacy STEP UP Grant. The interpretations of data and conclusions expressed in this manuscript are those of the authors and do not necessarily represent the views of ASPH, American Legacy Foundation, American Legacy Foundation Staff, or American
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2008, Addictive BehaviorsCitation Excerpt :Rates of regular and lifetime use were highest for cigars and ST. Overall, rates of ST and cigar use tended to be higher than those observed in studies conducted among adult civilian samples, while the prevalence of pipe use was similar (Ebbert et al., 2004; Giovino et al., 1994; Rigotti, Lee, & Weschler, 2000; Tomar, 2003b). Rates of bidi use (2.0%) are also similar to those observed among a sample of young adults from 15 states participating in the BRFSS (1.4%), which is the only other source of published data on bidi use in adults (Delnevo et al., 2004). Consistent with previous studies (Delnevo et al., 2004; Gilpin & Pierce, 2003; Hatsukami & Severson, 1999; Hrywna et al., 2004; Nelson et al., 1996; Nyman et al., 2002; Soldz et al., 2003; Tercyak & Audrain, 2002), cigarette smoking was associated with other forms of tobacco use in this study population.