Objective: To determine the practices and knowledge about chhaalia and paan masala chewing among school children in Mahmoodabad and Chanesar Goth, Karachi, Pakistan.

Methods: A cross-sectional study was conducted in three government schools of Mahmoodabad and Chanesar Goth, Jamshed Town, Karachi. Students of either gender were interviewed using a pre-coded structured questionnaire. In addition to the demographic data, questions included frequency of use, practices among friends and family and procurement of these substances. Knowledge about harmful effects, source of the knowledge and practices in relation to knowledge were also assessed.

Results: A total of 370 students, ages between 10 to 15 years were interviewed, of which 205 (55.4%) were boys. Thirty one percent of fathers and 62% of mothers were uneducated. The frequency of using chhaalia was 94% and that of paan masala was 73.8%, with 85% being regular users and 95% had friends with similar habits. Majority (88%) procured the substances near their homes, chhaalia was considered harmful for health by 96% and Paan Masala by 60% of the students. The commonest reason for continuing use was good taste (88.5%) followed by company of friends (57%). Knowledge about harmful effects was adequate in both "daily" and "less than daily users".

Conclusion: The frequency of chhaalia and paan masala chewing, among school children in lower socio-economic areas is high. The probable reasons might be the taste, widespread use of these substances by family members and friends, low cost and easy availability. Although knowledge about harmful effects of these habits was adequate, but very little students knew about Oral Submucous Fibrosis (OSMF).

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