Smoking among females in Bangladesh: A systematic review and meta-analysis

Abstract

Female smoking in Bangladesh is a growing public health concern, though the overall prevalence remains lower compared to men. Cultural norms and social stigma surrounding women’s smoking habits have traditionally kept the rates relatively low. However, the influence of urbanization, changing lifestyles, and increased access to tobacco products may be contributing to a rise in female smoking rates. A comprehensive search across multiple databases identified 25 studies for the meta-analysis. The I² statistic and Q-tests were used to assess heterogeneity. A random-effects model and subgroup analyses were conducted. Egger's test and funnel plots were utilized to evaluate potential publication bias. Meta-regression analysis was performed. Sensitivity analysis was conducted to assess the robustness of the meta-analysis. All analyses were performed using STATA 17. The results showed that women's pooled smoking prevalence was 5.50 % (95 % CI: 3.19–7.81) based on 25 selected studies (n = 71,824). The pooled prevalence was 4.90 % (95 % CI: 1.18–8.62) from 2001–2008, dropped to 3.11 % (95 % CI: 1.09–5.12) in 2009–2016, and then rose to 6.28 % (95 % CI: 1.67–10.89) in 2017–2024. Among age groups, the prevalence stood at 6.39 % for those aged ≥ 15 and slightly decreased to 5.36 % for those ≥ 18. For students, the pooled prevalence was 7.61 %. Public health interventions should emphasize smoking cessation programs, with a particular focus on implementing prevention strategies targeted at younger women. Community outreach and awareness efforts will further promote smoking reduction across all age groups.