Flavored Asian Cigarettes are Extra Harmful

CHARLOTTESVILLE, Va. -- Flavored Asian cigarettes, found to be even more harmful than regular ones, are gaining a foothold among minority youth, according to a study of New Jersey middle- and high-schoolers published in the American Journal of Health Behavior.

Called “bidis,” the exotic cigarettes from India and Southeast Asia are made of tobacco wrapped in a leaf and tied with a string. For the U.S. market, vanilla, cherry, root beer or other flavors are added.

After sampling the New Jersey youth, the study found that about 12 percent of middle-school students and 34 percent of high-school kids used any kind of tobacco. In addition, 5 percent of the middle-schoolers and 9 percent of high-schoolers said they used bidis.

Black high school students were more likely to use bidis than white students. In middle school, Hispanic and black students were more than twice as likely as whites to smoke them.

Bidis’ candy-like taste and a street reputation as “natural” products lead young people to consider them safer than ordinary cigarettes, said Mary Hrywna, of the University of Medicine and Dentistry of New Jersey in New Brunswick, N.J.

But bidis deliver more nicotine than conventional cigarettes, increasing the likelihood of addiction and raising the risk of cancers of the throat, mouth, lungs, esophagus, stomach and liver, according to the researchers.

Because enforcement of laws governing tobacco sales to minors concentrates on cigarettes, products like bidis or snuff are probably easier to buy, said Hrywna. Other researchers have found that bidis are often sold without tax stamps, suggesting they are imported illegally and thus can be sold more cheaply than conventional cigarettes.

“A comprehensive approach to youth tobacco prevention and cessation campaigns must address other tobacco products as well as cigarettes,” said Hrywna. Those approaches should also pay attention to groups like black youth, who use bidis, cigars and cigarettes about equally.

Future research should try to understand just why minority youth are so attracted to bidis, said Hrywna. Tobacco control efforts must also combat the illusion that they are not as harmful as regular cigarettes.
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