Background: Cigarette smoking among youth has become a major public health problem in many developing countries like Bangladesh. Many smokers start smoking in their teens; then they become addicted and deepen the dependency during early adulthood, maintaining their smoking behaviour. Current literature from Bangladesh has not examined how peer effect, family influence and smoking-related knowledge impact smoking behaviour of the adolescent and young adults from the urban areas of the country. This study aims to fill this gap in the literature by investigating the smoking patterns of urban male adolescents and young adults in Bangladesh. The study aims to examine the family and peer influence on the behaviour of smoking of this population group. The study also explores how knowledge on harmful effects of smoking affects the participation decision of smoking by young adults and adolescents. Methods: This study is an educational institution-based cross-sectional study within the framework of the Global Youth Tobacco Survey (GYTS). Primary data has been collected from a sample of 995 urban male students aged between 10-24 years living in the seven divisional headquarters of Bangladesh. We use logistic regression and count data regression models to examine how smoking is associated with different factors. Results: Our results suggest that a person is 45% more prone to smoke a cigarette if any of the family members is a smoker. The likelihood of smoking is about six times higher if he is offered a cigarette by his friend, whereas the likelihood of being a smoker is 15-fold if he has a smoker friend, as the findings reveal. However, institutional and family awareness are not significantly related to smoking. Conclusion: Strong evidence of peer and family effect on smoking initiation indicates the need for effective smoking-prevention intervention at the national level, specifically targeted at family and educational institutions. The findings are also relevant for other countries which share the similar characteristics of Bangladesh in terms of adolescent smoking determinants.
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