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Bidi most harmful smoking tobacco product Bidi smoking is a major risk factor among Indian males promoting the incidence of lung and head and neck cancers. Separate studies on the impact of bidi smoking on lung and oral cancers, and cancers of larynx and hypo pharynx in men in the age group of 30-84 years conducted at Karunagappally in Kollam district have shown that bidi is the most harmful of all smoking tobacco products. The cohort study on the relationship between bidi and lung cancer, covering a total of 65,829 men, found that bidi smokers had a 3.9-fold increase in lung cancer incidence when compared to those who never smoked bidis. The study also found that lung cancer risk among former bidi smokers was higher than those who never smoked bidis. The number of bidis smoked and younger ages at which bidi smoking was initiated elevated the lung cancer risk. P. Bidi smokers also are found to be taking five puffs per minute compared to two puffs by cigarette smokers in the same time. All these contribute to higher carcinogenicity. Bidi smokers in Kerala spend nearly Rs.140 monthly on their tobacco habit. The study found that the risk of lung cancer was lower in former smokers than current smokers.

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