Background: Given the increasing blood cancer incidence in Tunisia and recent discoveries proving the involvement of environmental factors, this study examined the eco-health literacy of Tunisian secondary school students concerning this disease, their interest in knowing about it, and their emotional and behavioral attitudes towards leukemia risk.

Methods: This is a quantitative study; a cross-sectional survey was conducted among Tunisian youths. Data collection took place in five representative public secondary schools in the north, center, and south of Tunisia.

483 students, aged from 15 to 20 years old, completed a paper and pencil questionnaire and described their literacy level about blood cancer, as well as their attitudes and interest in the disease.

Statistical software (SPSS, v.25.0) was used to analyze the data.

Preliminary results: The results indicate low eco-health literacy scores concerning leukemia. Lack of knowledge and confusion about the causes, symptoms, and diagnosis of leukemia is a common finding at all school levels surveyed.

Most youths failed to identify all the carcinogenic (except tobacco) and non-carcinogenic risk factors. Pesticide use and exposure to electromagnetic radiation are not considered risk factors. Living in a polluted urban area or near a roadway in high traffic does not constitute a real risk situation for youths.

The leukemia risk perception and the fear level differed according to gender, with higher sensitivity among teenage girls.

Despite these low scores, most participants were interested in having more information about leukemia and cancers in general.

Conclusion: This investigation shows a lack of knowledge about leukemia and these environmental factors. Low scores, interest, and an information need for expressed by youths who should incite educational actors and curriculum designers to optimize content and innovate ICT adapted to this eco-health challenge.