Background:
Street children constitute one of the most vulnerable groups in India. Among marginalized children, they are at higher risk of developing early tobacco use and thus lifelong addiction. However, literature on the tobacco use among this segment of population is scarce in India. This study estimates the prevalence of tobacco use and associated health problems among street children in India.

Methods:
A cross-sectional survey was conducted from May 2015 to September 2015. We purposively selected 40 street children (Age, 6-18 years) under each of the randomly sampled ten NGOs working on rehabilitation of the street children in New Delhi. Data on key variables such as sociodemographic profile, health status, and tobacco use were captured using pretested semi-structured questionnaire. STATA version 13.1 was used for data analysis.

Results:
In total, 400 street children were surveyed (mean age 13.8 years). Majorities were males (80%) and fewer were females (20%). Almost all (92%) of the street children belonged to socially disadvantaged classes. Nearly one third of them were suffering from skin (32%), eye (18%) ear infections (12%) and cough (9%). Thirty seven percent (148) of the street children reported ever use of tobacco products; largely bidi (54%) and pan masala (45%). Among ever tobacco users, nearly a third reported tobacco use on daily basis (38%), once a week (26%), once in two weeks (21%), once in a month (15%). The mean age of tobacco product initiation was 11.2 years (boys) and 12.1 years (girls).

Conclusions:
Tobacco use among street children in India is high. Such data need to be collected from different parts of the country to develop anti-tobacco campaigns and supporting evidence based policy decisions for young and vulnerable population.