Social Influences on Adolescent Tobacco Smoking in Dhaka: The Role of Peers, Siblings, and Relatives

Background: Adolescent tobacco use remains a major public health concern in Bangladesh, where social influences play a critical role in smoking initiation. Objective: This study assessed the impact of peers, siblings, and relatives on adolescent smoking in Dhaka. Methods: This was part of large case-control study conducted among 182 adolescents aged 15–19 years. Data was collected on smoking status of peer and sibling smoking, and household tobacco use. Logistic regression was used to examine associations, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: The mean age of respondents was 17.35 years. Smoking prevalence was strongly associated with peer and familial exposure. Among ever-smokers, 91.3% had brothers who smoked (p < 0.01). Adolescents with a smoking brother had six times higher odds of smoking (OR = 6.562, CI = 1.387–31.052), while having a best friend who smoked also increased smoking likelihood (OR = 3.789, CI = 1.717–8.358). Relatives smoking inside the home were significantly related to adolescent smoking (p < 0.01). Conclusion: Peers, siblings, and relatives substantially influence adolescent tobacco use in Dhaka. Prevention should target these social networks through school-based resistance programs, family-focused interventions, and stronger enforcement of tobacco control policies to reduce adolescent smoking and progress toward a tobacco-free Bangladesh.