Background: Tobacco is the single most preventable cause of death in the world today. The objective of the present study was to assess the pattern of tobacco use, its ill health-effects and study the rural-urban variations in areas of district Jhunjhunu, Rajasthan.

Methods: A cross-sectional community-based study was performed, 150 subjects from urban and 150 from rural area were studied. A pre-tested pre-structured questionnaire was used to assess the type and pattern of tobacco consumption, quit rates, self-reported medical and objective oral findings.

Results: Tobacco usage in rural and urban areas was 38.67% and 22%, respectively. Bidi and zarda were most commonly consumed forms of tobacco in rural areas, while cigarettes and gutka were more popular in urban area. Smokeless form of tobacco consumption was almost equal to smoking rates in rural areas. The commonest age of tobacco initiation was in the second decade of life in both urban and rural areas. Quit rates were very low (3%). 36.3% tobacco-users self-reported medical symptoms and almost 90% had objective oral findings.

Conclusion: The magnitude of tobacco consumption is high in both urban and rural areas with definite rural-urban differences and associated ill health effects.

Key words: Smoking, smokeless tobacco, cross-sectional survey, health.