Prevalence and correlates of tobacco use among adolescents in Dhaka, Bangladesh: a cross-sectional study

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Abstract Background Tobacco use among adolescents in low- and middle-income countries is a public health concern. This study investigated the prevalence and correlates of ever and current tobacco use among adolescents in Dhaka, Bangladesh. Methods A cross-sectional survey was conducted among school-going adolescents aged 11–18 years in schools across Dhaka city between June and September 2022, using an opportunistic sampling approach. A structured questionnaire collected data on socio-demographics, tobacco use behaviours, exposure to second-hand smoke (SHS), tobacco advertising, and anti-tobacco education. Logistic regression analyses were performed to identify correlates of tobacco use, adjusting for confounders. Results A total of 2,593 adolescents participated in the survey (mean age: 15.6 years, SD = 1.6); 55.6% (n = 1,442) were male. Ever and current tobacco use prevalence was 16.0% (95% Confidence Interval [CI]: 14.6–17.5) and 7.3% (95% CI: 6.3–8.3), respectively. Cigarette smoking was the most common form of tobacco use (10.4%, 95% CI: 9.3–11.7, reported ever use), followed by smokeless tobacco (7.6%, 95% CI: 6.7–8.7) and non-cigarette smoked tobacco (3.3%, 95% CI: 2.7–4.0). Males had higher odds of both ever (Adjusted Odds Ratio [AOR]: 1.75, 95% CI: 1.33–2.28) and current tobacco use (AOR: 4.12, 95% CI: 2.43–6.99) compared with females. Adolescents aged 17–18 years were more likely to be current users than those aged 11–13 years (AOR: 3.27, 95% CI: 1.36–7.85). Exposure to SHS at home and tobacco advertising at points of sale were significantly associated with higher odds of both ever (AOR: 1.65, 95% CI: 1.27–2.16 and AOR: 1.61, 95% CI: 1.23–2.11, respectively) and current tobacco use (AOR: 1.75, 95% CI: 1.19–2.59 and AOR: 1.59, 95% CI: 1.07–2.36, respectively). In contrast, receiving anti-tobacco education was associated with lower odds of ever (AOR: 0.71, 95% CI: 0.52–0.99) and current tobacco use (AOR: 0.52, 95% CI: 0.33–0.84). Conclusion Tobacco use is prevalent among school-going adolescents in urban Bangladesh. Exposure to SHS and tobacco advertising are positively associated with tobacco use, while anti-tobacco education is negatively associated, underscoring the need for strong tobacco control measures in Bangladesh.

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