Bidi smoking behind squamous-cell lung cancer in rural males: PGIMS study

A study by PGIMS researchers has indicated that smoking of bidi is the leading cause behind squamous-cell lung cancer in rural male population.

The researchers say the absence of filters in bidis, high-puff frequency and higher quantities of nicotine and tar, as compared to cigarettes, make bidi-smoking more hazardous.

The study is based on the cross-sectional demographic data of patients who visited the Thoracic Oncology Clinic at the Department of Pulmonary and Critical Care Medicine of the PGIMS between September 2022 and August 2024. "As many as 855 patients were diagnosed with lung cancer in these two years and 95.2 per cent were smokers, of whom 99 per cent were bidi-smokers," said Dr Pawan Kumar Singh, Associate Professor at the department and principal investigator of the study.

The study, carried out under the supervision of Prof (Dr) Dhruv Chaudhry, Head of the Department, concluded that squamous-cell lung cancer is still the most common type of non-small cell lung cancer (NSCLC) in rural males.

Over half of the tumours were central. Filter-less tobacco-smoking (bidi) may be contributing towards such differences in tumour characteristics, it said.

Professor Chaudhry said November 1-30 was being observed as Lung Cancer Awareness Month by the International Association for the Study of Lung Cancer (IASLC). "India, with over 1.4 billion population, is a significant contributor to the global lung cancer burden. Despite representing 65 per cent of India's total population, rural areas are underrepresented in lung cancer epidemiological studies. In this study, we analysed the data from the university-teaching hospital that primarily serves the rural population, where bidi smoking is more prevalent. We compared our data with other centres," he said.

The doctors said immunotherapy had been found effective in the treatment of lung cancer. "Clinical trials of immunotherapy in treatment of lung cancer are being carried out at the PGIMS, under which testing as well as treatment facilities are being provided to the patients free of cost," they said.