Tobacco remains the greatest single cause of preventable morbidity and mortality worldwide. It is likely to cause 1 billion deaths in the 21st century, 70% and 80% of them in low and middle income countries. Bidis are the main way tobacco is smoked in South Asia, with an estimated 69 million men and 8 million women regularly using bidis in India alone. Bidis cause chronic health conditions that deplete the labour force and weaken the potential for economic progress in the country, as well as killing an estimated 300,000 people each year. Bidi use is starting to decline modestly in the face of changing fashions and tobacco control measures. This has implications for the estimated 4.4 million people, 90% of them women, in bidi-dependent livelihoods.
India is a signatory to the World Health Organization (WHO)’s Framework Convention on Tobacco Control. The first ever treaty of its kind negotiated by the WHO, the FCTC includes Article 17, ‘The provision of economically viable alternatives to tobacco production’. However, implementation of this Article is hampered by industry arguments concerning the importance of tobacco to the Indian economy and the embedded, swadeshi nature of bidis in Indian life and culture. Such policy dystopia arguments lack the voices of those working in the bidi industry, which is organized differently to transnational tobacco manufacturing, the primary (but not exclusive) focus of the FCTC. The working conditions and wages of most bidi rollers deeply compromise SDG8, ‘Decent Work and Economic Growth’, while the occupational health problems caused by their constant exposure to tobacco causes conflicts with SDG3, ‘Health and Wellbeing’, even before their product reaches the market.