Introduction:
India, after African countries, has the world's second largest tribal population. India is home to approximately half of the world's autochthonous people, making it home to many tribes with interesting and varied origins, customs, and social practices. The current study was conducted to assess tobacco use, prevalence of oral cancer, and awareness among Malayali tribes, Yelagiri Hills, Tamil Nadu, India.

Methods:
In 2010, a cross section survey among 660 was conducted in the 14 tribal villages of Yelagiri Hills, who had completed 18 years of age, had lived in the area for more than 15 years, were present on the day of the examination, and were willing to participate. A pre-tested questionnaire was used to collect data on demographics and tobacco habits. A single examiner performed an intra-oral examination to determine the Oral Health Status using the WHO Oral Health Surveys - Basic Methods Proforma (1997). The statistical analysis using SPSS version 19, demonstrated a significant prevalence of potential oral malignant lesions and a high rate of tobacco use. The population was followed up at regular intervals next 8 years, and in 2018 was analysed for tobacco use and oral cancer awareness.

Results:
In 2010, 57.7% of the 660 study population had no formal education. 75% of the study population drank alcohol on a regular basis. Among those who used tobacco, 26% smoked beedi, 10.9% smoked cigarettes, 65% chewed raw tobacco, 18% chewed Hans, and 28% used both smoking and smokeless form of tobacco. In 2018, there was a significant decrease in tobacco use (37%), increased awareness of the health risks of tobacco use among adolescents, decreased potentially malignant oral lesions and oral cancer prevalence among the population.

Conclusions:
A continuous follow up and awareness creation of the tobacco hazard can help to reduce the menace of tobacco in this population.