Background:
Organizers of most mass gatherings offer basic health services to attendees, and this is especially true of events of longer duration like the Hajj, the Olympics, or the Kumbh Melas in India. In 2015, at the world's largest mass gathering, the 35-day Kumbh Mela in Nashik, the government offered basic primary care to the estimated 10 million visiting pilgrims Prevalent studies to report tobacco use in mass gathering is not cited in the literature. Hence a study was planned to provide useful insights in the rising trends of diseases among the public during the mass gathering like Kumbh Mela.

Methods:
The study was planned to understand the pattern of tobacco use, among people visiting Kumbh Mela. A convenience sampling was undertaken at the temporary clinic established by the public health department at Nashik and Tribakeshwar. A total of 5302 visitors voluntarily opted for screening services offered for 13 days at Tapovan hospital in Nashik and for three days at the Rural Hospital in Trimbakeshwar.

Results:
The different types of tobacco consumption reported were in the form of smoking (24.6%), smokeless (28.4%) and both smoking and smokeless (2.4%). Tobacco use was found to be more in males (79.6%) as compared to females (20.4) The participants who were consuming both smoking and smokeless tobacco had 85.3% of premalignant lesions as compared to smoking (78.7%) and smokeless (68.3%) alone. Among different pre-malignant lesions examined, majority were smokers palate (22.4%), tobacco pouch (16.6%), leukoplakia (11.8%) and erythroplakia (10%).

Conclusions:
Mass gathering offers important public health surveillance for monitoring disease trends among the masses. The burden of undetected (and untreated) NCDs in India remains economically crippling. Until such time that the effective primary care is widespread and accessible, active surveillance efforts remain critical to combating NCDs.