Until the 50s, many district headquarters of the country were not touched by roads. At that time, it was not even possible to imagine the condition of driving a motor in the village as it is now. Communication and transportation were beyond the reach of common people in hilly districts.

Poor slums did not have enough schools and did not have the opportunity to study. Due to the lack of development infrastructure, there were no educational and social organizations to increase the level of awareness among the common people in the slums, so the knowledge about health was very low .

So much so that the general knowledge that the consumption of tobacco products spoils health and causes diseases was not much for the residents of the poor areas. Nor was there an effective government mechanism to impart such knowledge to them . 

If you have to give an example of an undeveloped and backward district in terms of awareness, the names of districts like Humla, Jumla, Kalikot, Manang, Mustang etc. will be taken.