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.