Bidis (pronounced "bee-dees") and kreteks (pronounced "cree-techs") are kinds of cigarettes usually imported to the United States from other countries. Both have higher concentrations of nicotine, tar, and carbon monoxide than conventional cigarettes sold in the U.S.

Bidis

Bidis are small, thin hand-rolled cigarettes imported primarily from India and other Southeast Asian countries. The tobacco in bidis is wrapped in a tendu or temburni leaf (plants native to Asia) and may be secured with a colorful string at one or both ends. They can be either flavored or unflavored. Despite their small size, their toxin levels are higher than manufactured cigarettes because of the need to puff harder to keep bidis lit.

Kreteks

Kreteks are sometime referred to as clove cigarettes and are typically imported from Indonesia. They contain a mixture consisting of tobacco, cloves, and other additives. They may also contain a wide range of exotic flavorings and eugenol, which has an anesthetic effect, allowing for greater and deeper inhalation.

Health Effects of Bidi and Kretek Use

The existing research on the health effects of bidi and kretek smoking has not been conducted in the United Sates, but instead in India and Indonesia. The Indian studies indicate bidi smoking is associated with similar adverse health effects as cigarette smoking, including increased risk of lung, oral, stomach, and esophageal cancer. Bidi smoking is also associated with a more than three-fold increased risk for coronary heart disease and heart attack and a nearly four-fold increased risk for chronic bronchitis, according to the Indian research.

Research in Indonesia indicates that kretek smokers have 13-20 times the risk of abnormal lung function compared with nonsmokers. Kretek smoking is associated with an increased risk of acute lung injury, especially among individuals with asthma or respiratory infections.

Current Estimate of Bidi and Kretek Use in the U.S.

As little research has been done in the United States regarding the prevalence of bidi and kretek smoking, there are no national estimates regarding use among U.S. adults. However, an estimated three percent of high school students (males at four percent and females at two percent) and two percent of middle school students (males at three percent and females at two percent) are current bidi smokers. An estimated three percent of high school students (males at three percent and females at two percent) and two percent of middle school students (males at two percent and females at one percent) are current kretek smokers.

Source: Centers for Disease Control and Prevention, Smoking and Tobacco Use. “Fact Sheet: Bidis and Kreteks,” February 2007.