Introduction Tobacco is the single most preventable cause of deaths globally. India is the second largest consumer and third largest producer of tobacco. A plethora of tobacco products are consumed. India has highest number of oral cancer cases globally and bears one fourth of the global burden.

With the smoke free public places legislation being implemented since 2nd October 2008, smoking is prohibited on public transport bus premises in India. Tobacco addiction is common among the commuters, drivers, conductors and other staff of the public transport department.

The present study was conducted to understand the knowledge, attitude and practices (KAP) regarding harmful effects of tobacco among the public transport bus staff, to educate them regarding the importance of smoke free legislation and health hazards associated with tobacco use, to support them in tobacco cessation, to conduct oral cancer screening and to assist in the further management.

Materials and methods Around 4000 public transport bus employees in Mumbai were enrolled after explaining the programme and obtaining informed consent. They were interviewed and their KAP regarding tobacco was recorded. The employees were then given detailed health education. They were screened for oral cancers and counseled for tobacco cessation. The screened positive employees were referred for diagnostic evaluation and management.

Results 4000 public transport bus employees were enrolled. Amongst them 1691 (42.28%) were tobacco users. Smokeless form of tobacco use was dominant, 1561 (92.31%). All 4000 employees participated in oral cancer screening and were enrolled for tobacco cessation counselling. 743 employees were screened positive, 592 complied to referral for diagnostic evaluation and 534 employees were clinically diagnosed with oral pre-cancers

Conclusions Tobacco use and oral pre-cancers are high among the public transport bus employees in Mumbai. Hence, awareness, oral cavity screening and tobacco cessation counseling should be incorporated within their annual health check-up.