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Objectives: This study sought to increase government, civil society and media attention to the tobacco-poverty connection in Bangladesh, particularly as it relates to bidi-dependent livelihoods., Data Sources: This study consisted of a literature review that examined the socioeconomic impacts of tobacco farming, the working conditions of tobacco workers and the impact of tobacco on consumers, and a primary research study among bidi workers and users. The research included in-depth and semistructured interviews and focus group discussions among bidi workers and a closed-ended quantitative survey among bidi users., Data Synthesis: Most bidi worker families earn about $6.40 per 7-day work week, leaving them below the poverty line. The majority of bidi workers are women and children, classified as unpaid assistants, who toil long hours in toxic environments. Bidi users are primarily low-income earners who spend up to 10% of their daily income on bidis; the average proportion of income spent on bidis decreased as income increased. If bidi expenditures were reduced and spent instead on food or local transportation, many higher value jobs could be created. This could also mean better health and nutrition for those currently engaged in bidi work., Conclusions: The results of this study illustrate the linkages between tobacco and poverty. Tobacco control is not simply about health and the environment, but also about the living conditions of the poorest of the poor. If we are to improve the lives of the poor, we must address the root causes of poverty, which include the production and use of tobacco.

Bidis, or hand-rolled, filterless tobacco cigarettes, are largely marketed to and consumed by the poor in Bangladesh. In exploring perceived rationales and the situational contexts of smoking, this study identifies the crucial connections between bidi smoking and the social and economic forces that influence choices and shape the contexts of individual suffering. Ethnographic research in Netrakona District revealed that inexpensive bidis were used to gain relief from physical ailments specific to the poor, such as hunger, indigestion and constipation. Bidis were found to be a socially accepted mood-altering drug that symbolizes relief from their everyday tensions, angers, perceived exploitations and disappointments. I argue that both cultural norms of reciprocity and hierarchy as well as the socio-economic structure of Bangladesh with its inequality, poverty and exploitation contribute to the tobacco consumption and related health problems of the poor. [ABSTRACT FROM PUBLISHER]