RACHEL MARTIN, HOST:
India has banned e-cigarettes. The move is preventative. Vaping isn't widespread in India, but other forms of tobacco are. India has the second-largest number of smokers in the world after China. NPR's Lauren Frayer reports from Mumbai.
LAUREN FRAYER, BYLINE: At a tiny kiosk on a Mumbai lane choked with rickshaws, Chandrabhaan Chaurasia (ph) is selling paan - leaves sprinkled with spices. It's a cheap street snack across South Asia.
So he takes a leaf and is spreading a bunch of different spreads on it - herbal, spicy spreads. It smells nice. And then he adds...
CHANDRABHAAN CHAURASIA: Tambakoo - tobacco.
FRAYER: Dried tobacco. He folds the leaf into an edible little parcel and sells it for about 11 cents. He's also got single-serving packs of chewing tobacco. Another kiosk sells hand-rolled leaf cigarettes called beedis. All of these are way cheaper than brand-name, packaged cigarettes.
GAURAVI MISHRA: When we look at Western countries, it's mainly the cigarettes. But for us, we consume more of smokeless tobacco than smoking forms of tobacco.
FRAYER: Dr. Gauravi Mishra works at a hospital right across the street from these kiosks, and she sees what their products do. She's just biopsied a boil inside the mouth of a patient, Madhukar Patil (ph), who's been chewing tobacco for 10 years.
MADHUKAR PATIL: (Speaking Marathi).
FRAYER: Patil, his mouth filled with gauze, says he didn't realize just how bad chewing tobacco is. He's waiting for results, now, to find out if he has oral cancer. And he's not alone, Dr. Mishra says.
MISHRA: India has the highest number of oral cavity cancers. In fact, one-third of the global burden comes from only one country, and that's India.
FRAYER: Part of the problem is awareness. Cigarette packs have these grotesque photos of tumors on them. People know they're bad. But other tobacco products are sold loose and used as a stimulant, like chewing gum. Leaf cigarettes are green. They look organic. And they're seven to eight times more common in India than conventional cigarettes. They also provide a livelihood to millions of mostly female first-time workers.
(SOUNDBITE OF MUSIC)
FRAYER: Bollywood music blasts through dank alleys in Mumbai's red-light district. This is where Balamani Sherla (ph) hand-rolls those leaf cigarettes, beedis, on the floor of her one-room home.
BALAMANI SHERLA: (Speaking Telugu).
FRAYER: Sherla shows me how she cuts the leaves, rolls them with tobacco and ties them off with thread. She's 60, and she's been doing this for half a century. She makes 14 cents an hour. That's still a big help to Sherla's family. In fact, women who have this skill are coveted as brides.
SHERLA: (Speaking Telugu).
FRAYER: It used to be more profitable, though, Sherla says. This year, her wages fell after the Indian government hiked tax on all tobacco products to discourage use.
Ashwani Mahajan heads a national trade group that's lobbying against another tax hike, even if it benefits overall public health.
ASHWANI MAHAJAN: Smoking is a bad thing, and it affects our health badly. But the basic question is their livelihood.
FRAYER: Without wages from rolling tobacco, these workers could literally starve, Mahajan says. They live that close to the bone. He wants the government to retrain them for other jobs.
SIRI: (Speaking Telugu).
FRAYER: Sherla's 10-year-old granddaughter Siri (ph) bounces around the room as her grandmother works. She's the exact age Sherla was when she started rolling beedis. Will Siri do the same, I ask?
SHERLA: (Speaking Telugu, laughter).
FRAYER: No way, Sherla says, laughing. This girl wants to be a doctor. Lauren Frayer, NPR News, Mumbai.
(SOUNDBITE OF PRASANNA'S "BOWLING FOR PEACE") Transcript provided by NPR, Copyright NPR.