Background: Cigarette smoking is a shared risk factor for a variety of health conditions. Aims: To estimate the prevalence of cigarette smoking among Iranian adolescents and young adults. Methods: In this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Scopus and domestic databases from January 2001 to December 2018. Cross-sectional studies that reported the prevalence of cigarette smoking among high school students, university students or general population aged 14–30 years were eligible. Data on prevalence of smoking, age and gender of subjects, sample size, date, and location of studies were extracted by 2 independent reviewers. Results: We included 99 studies in the analysis. For high school students, the pooled life-time prevalence of cigarette smoking was 13% in girls and 23% in boys. For university students, the life-time prevalence was 11% in women and 33% in men. The pooled prevalence of current and regular smoking among high school boys was 9% and 5%, respectively, compared with 3% and 1% in girls. The pooled prevalence of current and regular smoking among male university students was 22% and 11%, respectively, compared with 5% and 1% among female students. The prevalence of current smoking among the general population aged 15–24 years was 3.3–13.9%. The prevalence of regular smoking among this population was 1.0–10.2%. Conclusion: Cigarette smoking is notable among Iranian young adults especially boys and university students. Our findings call for reinforcement of tobacco prevention and control policies across Iranian schools and universities.
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