BACKGROUND: The bidi industry in India is a critical public health and socio-economic challenge, deeply entrenched in cultural and economic practices. Bidis, the most widely smoked tobacco product in India, contribute significantly to the national burden of non-communicable diseases, including cancer and cardiovascular illnesses. Despite existing regulatory frameworks such as the Cigarettes and Other Tobacco Products Act, 2003 (COTPA), and India's commitment to the WHO Framework Convention on Tobacco Control, enforcement gaps and regulatory loopholes persist. The informal nature of the bidi industry and its dependence on unorganized labour further exacerbate the public health crisis.
METHODS: This review systematically analysed existing regulatory policies and frameworks for bidi production, distribution, and consumption in India. Using a PRISMA-guided approach, 125 records were identified, of which 36 met inclusion criteria. Key sources included policy documents, academic articles, and grey literature, focusing exclusively on smoked tobacco. Excluded were documents related to smokeless tobacco or unrelated regulatory policies.
RESULTS: The analysis revealed critical gaps in India's tobacco control strategies. The informal nature of the bidi sector, reliance on underregulated labour practices, and lenient taxation policies undermine efforts to reduce consumption. Enforcement of health warnings and sales restrictions remains inconsistent, especially in rural areas. Furthermore, environmental concerns such as deforestation and waste from bidi production and consumption lack adequate regulatory attention. Despite policies aimed at supporting bidi workers, poor wages and hazardous working conditions persist.
CONCLUSIONS: India's bidi control efforts require a comprehensive, multi-dimensional approach to address public health, labour welfare, and environmental sustainability. Strengthening regulatory enforcement, closing policy loopholes, and promoting sustainable alternative livelihoods for bidi workers are critical to reducing the public health and ecological burden. Tailored public awareness campaigns and improved taxation mechanisms can further support these efforts, ensuring a more robust and effective tobacco control strategy.