political clout. Bidi industrialists are in political circles at very high levels in all parties,” said Gupta, a leading researcher into the health impact of tobacco.
Up to 900,000 Indians die every year from causes related to tobacco use, according to government figures, and researchers have warned that figure could reach 1.5 million by the end of the decade without more deterrence.
While a packet of 20 normal cigarettes can cost in excess of 150 rupees, a bundle of 15 bidies can sell for as little as five rupees, their price kept low by favourable tax rates.
Most bidi smokers are poor men living in rural areas, but they are not alone in risking their health for the small sticks.
Up to 90 percent of the roughly 5.5 million bidi rollers are female, according to the All India Bidi, Tobacco and Cigar Workers Federation, with the government estimating up to a quarter are children.
Most of the rollers are non-smokers.
But continuously exposed to tobacco dust, many suffer from high rates of respiratory diseases including tuberculosis and asthma, as well as skin and postural problems, studies have shown.
A 2010 study of bidi rollers in the state of Bihar found that more than 70 percent of the workers suffered from eye, gastrointestinal and nervous problems while more than half suffered from respiratory problems.
“It’s back-breaking work with a huge number of health hazards and the compensation for that is a pittance,” said Alok Mukhopadhyay, head of the Voluntary Health Association of India (VHAI), which has researched the plight of rollers.
Laws enacted in the 1960s and 70s to improve the welfare of workers only encouraged manufacturers to fragment production into smaller units to escape regulation, campaigners say, with the added benefit of tax exemption for producers who report output of fewer than two million bidis a year.
Just a fraction work in factories, with the vast majority home-based and dependent on a sprawling network of small-scale contractors of the major brands. While the set-up complicates calculations of the industry’s economic might, estimates of annual production range from 750 billion to 1.2 trillion sticks, suggesting a sector worth billions of dollars.
In backroom factories such as Alvi’s home in Uttar Pradesh’s Kannauj district, children often work alongside relatives to help them meet quotas.
“I don’t like it,” said Alvi’s 14-year-old niece Seema, pitching in after a morning at school.
“I want to go to school for longer, but I can’t because of bidi rolling,” said Seema, who dreams of becoming a teacher.
Nearby at the New Sarkar Bidi Factory — a ragtag operation in a derelict shell of a building — men and young boys work in near darkness packing bidis at lightning speed, first into mountains of colourful packets and then into boxes.
General manager Quazi Naseem Ahmed, who says his company turns over 400 million rupees a year from 16 factories, insisted the boys only appeared underage as they had been weakened by years of hard work.
Speaking to AFP in his office, Ahmed acknowledged it was a tough life but also rejected talk of a link to cancer.
“They are weak, they are dirty, they get tired, so they have low immunity but they don’t get diseases like TB or cancer,” he said.