Background:
India is experiencing an epidemic of tobacco use among its youth. Evidence suggests that smoking tobacco is likely to increase due to tobacco industry's youth centered marketing strategies. However, little is known about patterns of use and attitudes towards smoked tobacco products among children in Mumbai.

Methods:
A self administered survey was conducted among 1,558 students of 7^th, 8^th, and 9th grades in 50 randomly selected government run schools in Mumbai in 2014. The survey covered demographic information, questions about tobacco product use, perception of harms and family use of tobacco products among children. The results were analyzed using SPSS.

Results:
Cigarettes (2.5%, n=39) were the most commonly reported smoked tobacco product ever used, followed by bidis (2.1%, n=33) and hookah (0.3%, n=5). Majority of students identified cigarettes (70.3%, n=1095) and bidi (57.6%, n=897) harmful to health. However, only 8% (n=125) reported hookah as a harmful product. Boys were more likely to report ever using cigarettes and bidis as compared to girls (cigarettes: 3.4% vs 1.5%; bidi: 2.5% vs 1.5%). Students who smoked cigarettes were significantly less likely to believe they were harmful to health (OR=0.3; 95%CI=0.1-0.9). Students whose father used tobacco were more likely to report ever use of cigarettes. (OR=0.4; 95%CI=0.2-0.8).

Conclusions:
While the overall reported use of smoked tobacco products was low among the sampled students, the low levels of knowledge and lack of perceived harm associated with these products is worrying and may lead to higher smoked tobacco use in future. School-based tobacco control programs are needed to ensure students understand the risks of smoked tobacco use. Since reported use is low among students in grades 7, 8 and 9, this may be the ideal time to intervene. Given the correlation between parental and child tobacco use, involvement of parents in tobacco control programs targeting youth will prove beneficial.