Background. There is a paucity of data from India on changing trends in lung cancer. Objective. In this study, we analysed the spectrum of lung cancer patients in cigarette and bidi smokers and nonsmokers presenting to a tertiary care centre. Methods. A retrospective analysis of lung cancer cases diagnosed at the Vallabhbhai Patel Chest Institute between 2001 and 2013 was done. Results. Out of a total of 106 patients with lung cancer, 35 (33%) were non-smokers. Their mean age was 51.7±14.9 years [non-smokers (39.4±14.3), bidi smokers (57.5±10.9) and cigarette smokers (58.1±11.2)] (p<0.0001). Cigarette smoking was common among patients (34.9%). Smoking was predominantly seen in males (n=80, 77.5%) (p<0.05). History of biomass fuel exposure was observed in 9 (25.7%) non-smokers. Cough was the commonest symptom (n=90; 84.9%) followed by dyspnoea (n=80; 75.5%) and haemoptysis (n=48; 45.3%). On chest radiograph, right lung (n=52; 49%) was the most common site. Mass was the commonest radiological presentation. The bronschoscopy showed no visible abnormality in 51.4% of non-smokers. Endobronchial mass seen in 32.3%, 54%, 25.7% of bidi smokers, cigarette smokers and non-smokers, respectively. Non-small cell lung carcinoma was seen in 82.1%, squamous cell carcinoma in 59.8% and adenocarcinoma in 40.2% patients. Squamous cell carcinoma was the predominant subtype amongst smokers, while adenocarcinoma was the commonest histological subtype in non-smokers (p<0.05%). Conclusions. The study concludes that bidi smoking poses a similar risk for lung cancer as with cigarette smoking. The focus of tobacco control programmes should be extended to all types of tobacco users to reduce the increasing incidence of lung cancer in India.