Background: Breast cancer (BC) is the most common cancer among women in India and shows an increasing trend. The mammography screening seems unfeasible as a public health service in India. Thus, breast self-examination (BSE), followed by clinical breast examination (CBE), is the affordable method to downstage BC. A cross-sectional study was conducted with senior school and college-going girls in Shillong (Meghalaya) to study the impact of girls’ academic level and family income on breast cancer knowledge and the prevalence of BC’s known risk factors in girls. Methods: A self-administered questionnaire was employed to collect relevant information. The data were analysed using statistical software SPSS version 22. The categorical data presented as frequency (%) and the comparison made using Chi-square or Fisher exact test. Results: (i) 78.2% girls knew about breast cancer, 19.2% of these were aware of BSE, and 22.9% of BSE knowing ever performed it (ii) Awareness of breast cancer and BSE, and its practice is significantly associated with their academic level and family income (iii) The consumption of alcohol beverages and physical activity of girls was positively associated with educational level and family income (iv) Body mass index (BMI) was weakly associated with family income with an insignificant relationship with academic level (v) oily food consumption related inversely with the level of education irrespective of family income (vi) there was a positive correlation between parents education and family income. Conclusions: The results show a severe lack of breast cancer knowledge in senior school and college-going girls under the survey. To spread community awareness, we suggest a public health policy-driven educational intervention through culturally relevant mass/social media on the risk factors of breast cancer and practice of BSE. It is also recommended that dedicated facilities be created for breast cancer early diagnosis in the public health system.

Background: Several national-level surveys have recognized a high prevalence of tobacco use in North-eastern (NE) India. However, information on tobacco use in specific population subgroups still lacks from the region. The present study determines the prevalence and influence of determinants like education and family income on tobacco use in senior school and college-going girls in Shillong, Meghalaya. Additionally, the prevalence of dual use of smoking and smokeless (SLT) tobacco with alcohol and non-tobacco Pan Masala has been examined. Methods: A cross-sectional study was conducted among 18-25 years girls in educational institutions in Shillong. Data were analysed using statistical software SPSS version 22. The categorical data presented as frequency (%). Chi-square was employed to see the association between variables. Results: (i) 8.10% of girls were current users of all forms of tobacco; 1.85% were smokers, 4.0% used SLT, and 2.25% were dual users of tobacco (ii) Of the 6.25% current users of SLT, 5.4% used a single smokeless tobacco product whereas 0.85% used multiple products of SLT (iii) 79.5% of tobacco smokers and 30.2% of current SLT users were dual users with alcohol (iv) 37.2% tobacco smokers and 18.5% SLT users were dual users with non-tobacco Pan Masala (v) Tobacco smoking was positively associated with educational status and family income whereas SLT use was independent of educational status and income of girls' families. Conclusions: The study shows a relatively high prevalence of tobacco use and dual tobacco use with alcohol in the study population of educated young adult girls, underscoring a public health concern. It is recommended that an education-based comprehensive awareness program be initiated for tobacco and alcohol control in Meghalaya to improve knowledge and health-seeking behaviour change in this high-risk subgroup to control increasing NCDs.