Bidis and Kreteks
Fact Sheets
Definition
Fact Sheets
Bidis are small, thin hand-rolled cigarettes imported to the United States primarily from India and other Southeast Asian countries.1,2 They consist of tobacco wrapped in a tendu or temburni leaf (plants native to Asia), and may be secured with a colorful string at one or both ends.1,2 Bidis can be flavored (e.g., chocolate, cherry, and mango) or unflavored.1
Kreteks—sometimes referred to as clove cigarettes—are imported from Indonesia and typically contain a mixture of tobacco, cloves, and other additives.3,4
Bidis and kreteks have higher concentrations of nicotine, tar, and carbon monoxide than conventional cigarettes sold in the United States.1,3,5,6
Health Effects
Bidis
Very little research on the health effects of bidis has been conducted in the United States;7 however, research studies from India indicate that bidi smoking is associated with cancer and other heath conditions.2
- Smoke from a bidi contains 3 to 5 times the amount of nicotine as a regular cigarette and places users at risk for nicotine addiction.7
- Bidi smoking increases the risk for oral cancer, lung cancer, stomach cancer, and esophageal cancer.6,8,9,10
- Bidi smoking is associated with a more than threefold increased risk for coronary heart disease and acute myocardial infarction (heart attack).6,11
- Bidi smoking is associated with emphysema10 and a nearly fourfold increased risk for chronic bronchitis.6
Kreteks
Little research on the long-term health effects of kreteks has been conducted in the United States; however, research in Indonesia indicates that kretek smoking is associated with lung problems.
- Kretek smoking is associated with an increased risk for acute lung injury (i.e., lung damage that can include a range of characteristics such as decreased oxygen, fluid in the lungs, leakage from capillaries, and inflammation), especially among susceptible individuals with asthma or respiratory infections.4
- Regular kretek smokers have 13 to 20 times the risk for abnormal lung function (e.g., airflow obstruction or reduced oxygen absorption) compared with nonsmokers.12
Smoking clove cigarettes can lead to severe health consequences; the following health problems have been associated with clove cigarettes:13
- Bronchitis
- Difficulty breathing
- Hemoptysis (i.e., coughing up blood)
- Pneumonia
- Respiratory infection
Neither bidis nor kreteks are safe alternatives to conventional cigarettes.4,5
Current U.S. Estimates of Bidis and Kreteks Use*
Bidis
|
1.7% |
of |
middle school students |
are current bidi smokers14 |
|
|
1.9% |
of |
male middle school students |
||
|
1.5% |
of |
female middle school students |
||
|
2.9% |
of |
high school students |
||
|
3.3% |
of |
male high school students |
||
|
2.4% |
of |
female high school students |
|
1.4% |
of |
adults aged 18–24 years |
are current bidi smokers7 |
0.3% |
of |
adults aged 18 years and older |
Kretkes
|
1.4% |
of |
middle school students |
are current kretek smokers14 |
|
|
1.7% |
of |
male middle school students |
||
|
1.0% |
of |
female middle school students |
||
|
2.8% |
of |
high school students |
||
|
3.6% |
of |
male high school students |
||
|
2.0% |
of |
female high school students |
NOTE: "Current" smoker in all estimate tables above is defined as smoking 1 or more bidis or kreteks in the 30 days preceding the survey.
References
- Centers for Disease Control and Prevention. Bidi Use Among Urban Youth—Massachusetts, March–April 1999. Morbidity and Mortality Weekly Report [serial online]. 1999;48(36):796–799 [accessed 2009 Apr 17].
- Bidi Cigarettes: An Emerging Threat to Adolescent Health. Archives Pediatrics & Adolescent Medicine. 2000;154:1187–1189 [cited 2009 Apr 17].
- Clove Cigarette Smoking: Biochemical, Physiological, and Subjective Effects. Pharmacology Biochemistry and Behavior. 2003;74:739–745 [cited 2009 Apr 17].
- World Health Organization.
Tobacco: Deadly in Any Form or Disguise
.
(PDF–144 KB) Geneva: World Health Organization, 2006 [accessed 2009 May 4]. - Determination of the Tar, Nicotine, and Carbon Monoxide Yields in the Smoke of Bidi Cigarettes. Nicotine & Tobacco Research. 2003;5(5):747–753 [cited 2009 Apr 17].
- Bidi Smoking and Health. Public Health 2000;114:123–127 [cited 2009 Apr 17].
- Bidi Cigarette Use Among Young Adults in 15 States. Preventive Medicine 2004;39:207–11 [cited 2009 Jun 16].
- Bidi Smoking and Oral Cancer: A Meta-Analysis. International Journal of Cancer 2003;106:600–604 [cited 2009 Apr 17].
- Risk Factors for Cancer of the Oesophagus in Kerala, India. International Journal of Cancer. 1991;49:485–489 [accessed 2009 Apr 17].
- Gupta PC, Asma S.
Bidi Smoking and Public Health .
(PDF–144 KB) New Delhi: Ministry of Health and Family Services, Government of India, 2008 [accessed 2009 Apr 17].
- Risk Factors for Acute Myocardial Infarction in Indians: A Case-Control Study. Lancet 1996;348:358–363 [cited 2009 Apr 17].
- Environmental and Occupational Lung Diseases in Indonesia. Respirology 1996;1:85–93 [accessed 2009 Apr 17].
- Clove Cigarettes: The Basis for Concern Regarding Health Effects. Western Journal of Medicine 1989;151:220–8 [cited 2009 August 21].
- Centers for Disease Control and Prevention. 2006 National Youth Tobacco Survey and Key Prevalence Indicators. [accessed 2009 Apr 30].
For Further Information
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO
Media Inquiries: Contact CDC's Office on Smoking and Health press line at 770-488-5493.
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