Calculation of population attributable risk for bidi smoking and oral cancer in south Asia

Mahbubur Rahman, Junichi Sakamoto, Tsuguya Fukui

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background. Bidi smoking, which is widely prevalent in India and in other south Asian countries, increases the risk of oral cancer as observed in case-control studies and metaanalysis. However, population attributable risk percent (PAR%) has not been determined yet. Materials and methods. Twelve case-control studies conducted in India, Pakistan, and Sri Lanka, which included information on bidi smoking and oral cancer, were analyzed countrywise to estimate PAR%. Results. The cumulative cases and controls were 4778 and 6271, respectively, based on 10 case-control studies conducted in India. Among the cases, 49.1% were bidi smokers and 7.7% cigarette smokers, while they were 19.9% and 10.3%, respectively, among controls. Pooled odds ratio (OR) of bidi smoking for oral cancer was 3.3 [95% confidence interval (CI), 3.0-3.6] and 2.6 (95% CI 1.8-3.8), respectively, based on fixed- and random-effects model. Cigarette smoking, on the other hand, did not show any significant association. PAR% of bidi smoking for oral cancer ranged from 4.7% to 51.6% on individual study basis, while they were 31.4% and 24.1%, respectively, based on OR derived from fixed- and random-effects models. PAR% was 5.8% and 8.7% based on single study estimate from Pakistan and Sri Lanka, respectively. Conclusions. Bidi smoking is considered to account for a sizeable number of oral cancers in south Asian countries, which implies that cessation programs should be formulated and implemented vigorously.

Original languageEnglish (US)
Pages (from-to)510-514
Number of pages5
JournalPreventive Medicine
Issue number5
StatePublished - May 2005
Externally publishedYes


  • Bidi smoking
  • Cigarette smoking
  • India
  • Oral cancer
  • Population attributable risk
  • South Asia

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Calculation of population attributable risk for bidi smoking and oral cancer in south Asia'. Together they form a unique fingerprint.

Cite this