Objective   To examine the prevalence of tobacco consumption among urban and rural residents in Hebei province and to provide evidences for developing effective tobacco control measures.

  Methods   Using stratified multi-stage cluster probability proportional to size (PPS) sampling, we selected 7 560 permanent residents aged 15 – 69 years in 28 diseases surveillance sites in Hebei province and conducted a household questionnaire survey from January to September in 2017.

  Results   Among the 6 900 residents with valid information, 1 705 were current smokers and the weighted current smoking rate was 24.86%; in the respondents, there were 2 163 ever-smokers, of which, 458 had quit smoking, with a weighted smoking cessation rate of 17.67%. Of the 5 077 respondents with the experiences of visiting various public places, 2 810 reported exposure to second-hand smoke in indoor public places, and the weighted second-hand smoking exposure rate in indoor public places was 60.32%. Of the 1 998 indoor workers, 933 reported exposure to second-hand smoke in workplaces, and the weighted second-hand smoking exposure rate among the indoor workers was 45.93%. Of the 6 900 respondents, 2 888 reported exposure to second-hand smoke at home, and the weighted rate of exposure to second-hand smoke at home was 46.12%. For all the respondents, the weighted awareness rates of smoking-related diseases were 46.41%, 51.75%, 85.87%, and 23.90% for stroke, heart disease, lung cancer and erectile dysfunction, respectively and the weighted overall awareness rate of the four smoking-related diseases was 20.57%; the weighted awareness rates of second-hand smoke-related diseases were 41.05%, 68.42% and 70.79% for adult heart disease, childhood lung disease, and adult lung cancer and the weighted overall awareness rate for the three diseases was 38.68%.

  Conclusion   The prevalence of tobacco smoking and exposure to second-hand smoke are still high and the cognition on smoking- and second-hand smoke-related diseases need to be improved among urban and rural residents in Hebei province.