The aim of the present study was to establish the relationship between tobacco use and periodontal health in an adult sample in India. A cross-sectional population-based study was conducted in a province of southern India. A total of 805 subjects between the ages of 30 and 69 years were interviewed, and clinical examinations were made by three cooperating dentists. The examiners recorded oral mucosal findings, gingivitis, and the Community Periodontal Index of Treatment Needs index using a WHO-621 Trinity probe. Among the 805 participants, 72% were males and 28% were females. Among regular smokers, 98% were males and 2% were females. In the studied population, 64.6% visited the dentist only when they had some dental problems. Oral mucosal findings were present more in of the regular smokers and chewing tobacco users than in the non-consumers. The maximum findings from six sextants indicate that non-consumers exhibited higher rates of healthy periodontium and bleeding on probing but lower rates of pockets than tobacco consumers. The present analysis shows that tobacco use exerts a strong and chronic effect on periodontium and oral mucosa and reduces bleeding on probing.