Background: Tobacco and harmful use of alcohol are two commonest modifiable risk factors leading to Non Communicable Disease. Tobacco and alcohol use during adolescence have potential long term health consequences and a possibility of future addiction. The present study aims to determine the prevalence of tobacco and alcohol use among school children in selected districts of India. Methods: A cross-sectional study was conducted among 4339 students (boys: 2587; girls: 1752) of 10-19 year sage group. Data were collected through a pre-tested questionnaire using the face-to-face interview method. Bivariate and multivariate analysis was done to determine the association between socio-demographic variables and tobacco and alcohol consumption. Results: The study showed that, overall the prevalence of tobacco use in any form is higher (31.5%) compared to the use of alcohol (7.9%) among the study subjects. 29% of the students do not have knowledge about the health concerns of alcohol use while 22% of students do not have knowledge about the health concerns of cigarette smoking. Significant association was found between the use of tobacco/alcohol with age, family/friends habit of tobacco/alcohol use and duration of watching television. Conclusion: Health education and knowledge about common risk factors of NCD need to be promoted among the higher secondary students. A broader and more comprehensive school based education strategy and a family based approach would be critical to prevent such unhealthy practices. Policy and its implementation on restricting availability of tobacco and unhealthy diets in and around schools will be an important step to prevent incidence of NCDs.