Background: Knowledge and individual perceptions about adverse effects of all forms of tobacco exert direct influence on the level of tobacco consumption in various socio-demographic groups. The objective of this study was to determine the nature, extent and demographic correlates of knowledge, attitudes and perceptions of use of tobacco among adults in low and middle income countries. Materials and Methods: The Global Adult Tobacco Survey, conducted in fourteen different countries from 2008-2010, was sourced for the data analyzed in this study. Descriptive statistical analyses were conducted to determine the prevalent knowledge and individual perceptions amongst adults about all forms of tobacco consumption. Results: There was relatively high awareness about the harmful effects of smoking tobacco with main awareness being about its relationship with lung cancer (>90% in most countries). In contrast, there was relatively low awareness about harmful effects of smokeless tobacco (< 90% in all countries except India and Bangladesh), and observed correlation of smoking tobacco with heart attack (40.6% in China, 65.1% in India) and stroke (28.2% in China, 50.5% in India). Conclusions: A large proportion of adults living in low and middle income countries possess adequate knowledge about smoking tobacco but have inadequate awareness as well as false perceptions about smokeless forms of tobacco. Popular beliefs of inverse relationships of tobacco consumption with knowledge, attitudes and perception of populations towards tobacco are challenged by the findings of this study.