The objective of this study is to estimate the number of premature deaths that can be attributable to cigarette and bidi manufactured and consumed over the last 100 years in India. Nearly 4.52 trillion cigarettes and 40.3 trillion bidis have been produced between 1910 and 2010, which are estimated to be responsible for nearly 100 million premature deaths (in which bidis contributed 77 million deaths) in adult men of ≥35 years. Some of these deaths will occur up to the
middle of this century. These estimates are derived from the most conservative datasets and yet present alarming mortality estimates. This communication calls for greater emphasis on epidemiological research and a review of existing tobacco control measures in India, which together need to inform measures needed for reducing tobacco use and restricting the proliferation of the tobacco industry.