Implementing FCTC Article 17 Through Participatory Research With Bidi Workers in Tamil Nadu, India

Abstract

Introduction The exploitation, poor conditions and precarity in the bidi (hand-rolled leaf cigarette) industry in India makes it ripe for the application of the FCTC’s Article 17, ‘Provision of support for economically viable alternative activities’. ‘Bottom up’, participatory approaches give scope to explore bidi rollers’ own circumstances, experiences and aspirations. Methods A team of six community health volunteers using a participatory research orientation developed a questionnaire-based semi-structured interview tool. Forty-six bidi rolling women were interviewed by pairs of volunteers in two northern Tamil Nadu cities. Two follow-up focus groups were also held. A panel of 11 bidi rollers attended a workshop at which the findings from the interviews and focus groups were presented, further significant points were made and possible alternatives to bidi rolling were discussed. Results Bidi workers are aware of the adverse impact of their occupation on them and their families, as well as the major risks posed by the product itself for the health of consumers. However, they need alternative livelihoods that offer equivalent remuneration, convenience and (in some cases) dignity. Alternative livelihoods, and campaigns for better rights for bidi workers while they remain in the industry, serve to undercut industry arguments against tobacco control. Responses need to be diverse and specific to local situations, i.e. ‘bottom up’ as much as ‘top down’, which can make the issue of scaling up problematic. Conclusion Participatory approaches involving bidi workers themselves in discussions about their circumstances and aspirations have opened up new possibilities for alternative livelihoods to tobacco. Implications Progress with the FCTC’s Article 17 has generally been slow and has focussed on tobacco cultivation rather than later stages in the production process. The bidi industry in India is ripe for the application of an alternative livelihoods approach. This study is one of the first to use participatory methods to investigate the circumstances, experiences and aspirations of bidi workers themselves.

Occupational health hazards of bidi workers and their families in India: a scoping review

“…Overall, we found 95 studies (96 reports) assessing occupational health hazards of bidi workers and their families 8–10 12 18–108. We found eight studies from the grey literature, while 87 studies were published.…”

“…We found 87 studies assessing occupational health hazards in bidi workers 8–10 12 18–43 45 47–51 53–67 69 71–84 87–90 92–108. We synthesised evidence on domains based on the medical specialty, to enable presentation which could be well understood by clinicians and policymakers, as well as by the general public.…”

“…Bidi workers reported dizziness, fever, chest pain, and pain in the hands, legs, shoulders, neck and back due to prolonged working hours in the same posture for bidi rolling. Many participants reported burning of eyes, respiratory irritation, chronic bronchitis, tuberculosis and overall health deterioration because of prolonged tobacco dust inhalation 44 70 74 83 87 88 91. Female bidi workers who rolled bidis at home in small huts with inadequate ventilation reported that tobacco dust remains in the home where their families and they spend most of their time, leading to respiratory illnesses 83…”