Bidis, or hand-rolled, filterless tobacco cigarettes, are largely marketed to and consumed by the poor in Bangladesh. In exploring perceived rationales and the situational contexts of smoking, this study identifies the crucial connections between bidi smoking and the social and economic forces that influence choices and shape the contexts of individual suffering. Ethnographic research in Netrakona District revealed that inexpensive bidis were used to gain relief from physical ailments specific to the poor, such as hunger, indigestion and constipation. Bidis were found to be a socially accepted mood-altering drug that symbolizes relief from their everyday tensions, angers, perceived exploitations and disappointments. I argue that both cultural norms of reciprocity and hierarchy as well as the socio-economic structure of Bangladesh with its inequality, poverty and exploitation contribute to the tobacco consumption and related health problems of the poor.