Objective  To analyze the prevalence of smoking and exposure to secondhand smoke (SHS) and their effects on stoke incidence among Bai ethnic minority residents in Yunnan province and to provide evidences for stroke prevention and control.

  Methods  We conducted a face-to-face questionnaire survey among 2 900 Bai ethnic minority permanent adult residents (≥ 35 years) recruited with stratified multistage random sampling in 9 villages of Jianchuan county, Yunnan province from April to May 2018.

  Results  Among 2 501 residents completing the survey, 762 were current smokers and the prevalence rate of smoking was 30.5%; 528 reported the exposure to SHS and the prevalence rate of SHS exposure was 21.1%; 155 were identified suffering from stroke and the prevalence rate of stroke was 6.2%. The results of multivariate logistic regression analysis indicated that after adjusting for sex, age, educational level and annual per capita income, the participants being current smokers had an significantly increased risk of stroke (odds ratio OR = 3.717, 95% confidence interval 95% CI: 1.624 – 2.231) compared to those being non-smokers; the results also demonstrated that among the participants being nonsmokers, those exposed to SHS had a significantly increased risk of stroke (OR = 3.690, 95% CI: 2.562 – 5.394) in comparison with the nonsmokers without SHS exposure.

  Conclusion  Among adult Bai ethic minority residents in Yunnan province, the prevalence of current smoking is high but the secondhand smoke exposure rate of nonsmokers is low; both smoking and secondhand smoke exposure could increase risk of stroke in the residents.