BACKGROUND The tobacco dusts get air borne during biddi making and it is inhaled by the biddi binders, which affects their health. RESULTS In a follow-up study, 86 biddi binders (male, 41; female, 45) were studied at a gap of 2 years. A high respiratory morbidity was observed among males than females both in the initial and follow-up study. The main complaints such as cough, sputum, and breathlessness showed high prevalence rates in the follow-up study. The high prevalence rates of weakness, giddiness, chronic diarrhea, and dyspepsia were noted in most of the cases the above complaints showed higher rates in the follow-up study. Pulmonary function test (PFT) values in the follow-up study of male and female biddi binders showed lowered compared with the initial study of same gender. In male and female biddi binders, the lung volumes SVC, FVC, FEV1, and the flow rates FEF0.2-1.2 l, FEF25%-75%, FEF75%-85% were significantly lowered in the follow-up study compared with the initial study. Age-related decrement in PFT was observed in both the studies. In nonsmokers, smokers, and ex-smokers, the PFT values are lowered. The current smokers have the lowest values in both the studies. With the administration of the bronchodilator aerosol (salbutamol) in 63 biddi binders (male, 27; female, 36), the effect of bronchodilator aerosol on the PFT parameters showed significant changes as all PFT parameters showed positive bronchodilatation. CONCLUSIONS The pattern of bronchodilator response on PFT values of the biddi binders suggests that the obstructions in the airways are reversible in nature.