Objective  To examine the prevalence of smoking and smoking cessation and awareness rate of smoking hazards among permanent residents aged 15 – 69 years in Gansu province to provide references for education on tobacco control in the population.

  Methods  From November 2015 to February 2016, we conducted a face-to-face questionnaire survey among 23 250 permanent residents aged 15 – 69 years recruited with multi-stage random sampling across Gansu province.

  Results  For the 21 320 residents completing the survey and after weighting, the overall smoking rate was 30.7% (95% confidence interval 95% CI: 29.3% – 31.5%); the current smoking rate was 27.5% (95% CI: 26.6% – 28.7%); and the rate of current daily smoking was 21.6% (95% CI: 20.8% – 22.7%). The smoking cessation rate was 12.1% (95% CI: 10.8% – 13.2%) among smokers. Only 16.2% of the current smokers reported the willingness to quit smoking in recent one year. For all the respondents, the awareness rate of correlation between smoking and the incidence of stroke, heart attack, and erectile dysfunction were 28.2%, 34.0%, and 18.2% and the awareness rate of correlation between second-hand smoke and heart diseases in adults, lung diseases in children, and lung cancer were 34.5%, 52.8%, and 54.9%, respectively.

  Conclusion  Among 15 – 69 years old permanent residents in Gansu province, the smoking rate is high but the awareness on tobacco hazards is at a low level; both the rate of smoking cessation and the proportion of willing to quit smoking are low among the smokers.