Assessment of Knowledge, Attitude, and Practice among Bangladeshi Adults on Tobacco Consumption: A Cross-Sectional Study

Background: Tobacco use continues to be a leading preventable cause of morbidity and mortality in Bangladesh. This study assessed the levels of knowledge, attitudes, and practices (KAP) regarding tobacco among Bangladeshi adults to inform control efforts.   Methods: A cross-sectional survey was conducted with 2,842 adults aged 18–64 years from urban and rural areas across all eight divisions of Bangladesh. Information on sociodemographic details, knowledge of the health risks of smoking, smokeless tobacco, and second-hand smoking, attitudes toward tobacco’s health effects, tobacco use behaviors, quit attempts and methods, duration of use, and exposure to second-hand smoke were collected. Descriptive statistics with 95% confidence intervals (CI) were used. Results: Knowledge of health risks associated with tobacco use was high. Among smokers, 98.8% recognized cancer, 95.2% lung diseases, 91.5% heart disease, and 82.9% stroke as potential outcomes. For smokeless tobacco (SLT) users, 97.4% identified mouth cancer, 91.2% gum disease, and 89.7% tooth decay. Knowledge of second-hand smoke dangers was also high: lung cancer (94.5%), increased risk of heart disease (85.8%), and stroke (80.5%). Attitude scores showed strong support for tobacco avoidance. Despite this, the prevalence of tobacco use was 19.2% for smoking and 17.9% for smokeless tobacco users. Among smokers, 81.5% used cigarettes and 24.7% used bidis, and 79.2% of smokeless tobacco users used Jarda. Overall, 34.0% used either smoking or smokeless tobacco, with 3.1% dual users. Second-hand smoke exposure was more common in public places (78.9%) than in workplaces (47.9%) or inside homes (29.3%). Conclusions: While knowledge and attitudes toward the health risks of tobacco are high, the rates of smoking and smokeless tobacco use remain considerable, with frequent daily consumption, limited use of proven cessation methods, and high exposure to second-hand smoke in public places, highlighting gaps in the enforcement of smoke-free policies.