Bangladesh has nearly halved tobacco use since 2000 — but one adult in three still uses it, and half of men

Introduction

Few risk factors in Bangladesh have moved as far in a generation as tobacco. The WHO estimates that 57.9% of adults aged 15 and over used tobacco in 2000; by 2024 the figure was 32.0%.¹ That is a fall of 25.9 percentage points, or 45% in relative terms, in 24 years.

57.9% → 32.0%

Age-standardized share of Bangladeshi adults (15+) who currently use any tobacco product, smoked or smokeless, 2000 and 2024.

The decline is real but incomplete. Roughly one adult in three still uses tobacco, and the burden is far from evenly spread. Globally, tobacco kills more than 7 million people a year, including over 1.6 million non-smokers exposed to second-hand smoke, according to the WHO.² This article sets out what the estimates show, who is still using tobacco, how Bangladesh compares with its neighbours, and what the WHO’s evidence-based toolkit suggests.

A note on the numbers: they are WHO modelled estimates, standardized to a common age structure so that countries and years can be compared. “Current use” covers daily and non-daily use of any tobacco product, including cigarettes, bidis, waterpipes and all forms of smokeless tobacco, and excludes e-cigarettes.³ They are not annual survey counts, and single-year changes should be read with caution.

A steady fall, five years at a time

The estimates fall in every reported period: 50.9% in 2005, 44.2% in 2010, 39.1% in 2015, 34.9% in 2020 and 32.0% in 2024.¹ The pace has slowed. Prevalence dropped by 7.0 points between 2000 and 2005, 6.7 between 2005 and 2010, 5.1 between 2010 and 2015, 4.2 between 2015 and 2020, and 2.9 between 2020 and 2024 (four years rather than five).¹

The slowdown matters because the health burden of tobacco accumulates over decades. Bangladesh’s probability of dying between ages 30 and 70 from cardiovascular disease, cancer, diabetes or chronic respiratory disease was 18.1% in 2021, down from 24.7% in 2000.⁴ The two series coincide in time, but the data used here do not show how much of the improvement is due to tobacco, and a causal link should not be read into the comparison.

Women led the fall; men have barely moved

The headline decline hides a sharp divide. Among women, prevalence fell from 48.2% to 14.0%, a drop of 34.2 points, or 71%.¹ Among men, it fell from 67.6% to 49.9%, a drop of 17.7 points, or 26%.¹ In 2000 men were 1.4 times as likely as women to use tobacco; in 2024 they were 3.6 times as likely.

In practical terms, about one man in two still uses tobacco. A national average of 32% therefore describes two very different populations: a minority of women, and a large share of men who have changed their habits much less. Any strategy that is built around the average will miss that gap. The data used here do not break prevalence down by age, income, education or division, so they cannot say which groups of men are driving the figure; the Global Adult Tobacco Survey and Demographic and Health Survey microdata are the places to look.

High by regional and world standards

Despite the progress, Bangladesh’s 2024 rate of 32.0% is the highest among the countries compared here. Indonesia is at 31.0% and Nepal at 28.7%. India (22.6%), Viet Nam (21.1%), Sri Lanka (20.7%) and Pakistan (17.9%) are lower.⁵ The South Asia average is 23.6% and the world average is 20.3%, so Bangladesh’s rate is about 1.6 times the global figure.⁵

The comparison has a limit. The peers differ in their starting points, in the mix of smoked and smokeless products, and in how their surveys are done, and the series are modelled by the same WHO method precisely to make them comparable, not to explain differences. What it does establish is that a further reduction of tobacco use is a realistic goal, since neighbours with similar incomes have lower rates.

What it will take

The WHO’s MPOWER package sets out six measures: monitoring tobacco use and prevention policies; protecting people from tobacco smoke; offering help to quit; warning about the dangers of tobacco; enforcing bans on advertising, promotion and sponsorship; and raising taxes on tobacco.² Read against the Bangladesh data, the priorities that follow are:

• Aim at men. With half of men still using tobacco, and the female rate already at 14.0%, the largest remaining gains lie in men’s use. Cessation services and warnings need to reach them in workplaces, transport hubs and primary care.
• Raise taxes toward the WHO benchmark. The WHO recommends tax of at least 75% of the retail price, and says only 41 countries had reached that level.² Whether Bangladesh’s current tax share meets it should be checked against the latest WHO report on the global tobacco epidemic before any target is set.
• Cover smokeless products. The estimate counts smokeless tobacco, so measures that address only cigarettes would leave part of the problem untouched.
• Publish more detail. Age, income and division breakdowns, and a new national survey, would show where the remaining users are and whether the slowdown after 2020 is real.
• Protect non-users. Second-hand smoke exposure causes cardiovascular and respiratory disease, including coronary heart disease and lung cancer;² smoke-free enforcement in public places and homes shields people who never chose the risk.

The long fall since 2000 shows that tobacco use in Bangladesh can change quickly. The slower pace since 2020, and a male rate near 50%, show that the easy part is probably over.