Related Experiment Video
Updated: Sep 4, 2025
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Concept of BIDI years: Relevance to the perioperative period
Rashmi Datta1, Shalendra Singh2, Arjun Joshi3
1HoD Emergency Medicine, HIMSR and HAHC Hospital, Jamia Hamdard, New Delhi, India.
Insights
This study introduces "bidi years" to quantify bidi smoking impact, finding 43 bidis daily equal one cigarette pack-year. Bidis have higher carbon monoxide, necessitating longer cessation periods before surgery.
Area of Science:
- Tobacco Research
- Public Health
- Chemical Analysis
Background:
- Cigarette smoking impact is measured in "pack years," but no equivalent exists for bidi smoking.
- Bidi smoking is prevalent in India, necessitating a standardized measure of cumulative exposure.
Purpose of the Study:
- To establish the concept of "bidi years" analogous to "pack-years" for cigarettes.
- To compare the toxicant content (nicotine and carbon monoxide) of bidis and cigarettes.
Main Methods:
- Analysis of nicotine and carbon monoxide in 30 random samples of common bidi and cigarette brands.
- Utilized high-pressure liquid chromatography for nicotine and gas chromatography for carbon monoxide analysis.
Main Results:
- Bidis showed significantly higher average nicotine (214.46 mg/dL) and carbon monoxide (70.4 mg/dL) content compared to cigarettes (616.31 mg/dL nicotine, 15.57 mg/dL CO).
- The weight of a cigarette is 0.56 times that of a bidi.
- Calculated equivalent of 43 bidis per day per year for one cigarette pack-year based on nicotine content.
Conclusions:
- Proposed equivalent of 43 "bidi years" for one cigarette "pack-year" based on nicotine.
- Higher CO content in bidis (4.5 times cigarettes) suggests longer cessation (24h vs 6h) is needed before surgery.
- Deeper inhalation of bidis may require longer abstinence for nicotine normalization despite lower content per stick.
Background:
The cumulative effect of cigarette smoking is usually measured by "pack years," but the same is not present for Bidis. This study was conducted to calculate the concept of "bidi years" in comparison to the concept of "pack-years" for a cigarette.
Methods:
Thirty random samples, each of bidis and cigarettes, were selected through a survey of common brands used by smokers in India. The nicotine and carbon monoxide (CO) contents were analyzed by high-pressure liquid chromatography and gas chromatography methods, respectively.
Results:
The average nicotine content in thirty samples of different Bidis and Cigarettes was 214.46 ± 57.8 and 616.31 ± 22.6 mg/dL, respectively (P < 0.001). The CO content with a lower mean of 15.57 ± 5.88 was observed in cigarettes as compared to 70.4 ± 22.08 in bidies (P < 0.001). The weight of one cigarette is 0.56 times that of the weight of one bidi. Based on the nicotine content, the equivalent pack years for bidis is calculated as 43 bidis per day per year.
Conclusion:
Based on the nicotine content, it is proposed that the equivalent for one cigarette pack-year or 20 cigarette years are taken as 43 bidis per day per year. Even though each bidi stick has an average of 0.46 times the nicotine content of cigarettes, longer abstinence as compared to cigarette is required to bring the nicotine level to normal due to the deeper puffs needed. With the CO content of bidis being 4.5 times that of cigarettes, it is advised that the minimum duration of cessation of smoking before operative procedures be 24 h as compared to 6 h for cigarettes.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management