Determinants of Plastic Waste Awareness, Preventive Practices, and Health Symptoms: An Urban‐Rural Comparative Cross‐Sectional Study in Bangladesh

ABSTRACT Background and Aims Plastic waste is an escalating environmental and public health threat, particularly in Bangladesh, where rapid consumption and inadequate waste management exacerbate associated risks. Evidence on urban‐rural disparities in awareness, preventive practices, and related health outcomes remains limited. This study compared these differences and identified key determinants to inform context‐specific interventions. Methods This comparative cross‐sectional study was conducted in 2022 among 768 respondents from urban (Dhaka) and rural (Tangail) settings. Households were selected using random route sampling, and eligible participants (≥ 18 years, both male and female, ≥ 1‐year residency) were selected through simple random sampling. Data were collected via face‐to‐face interviews using a pretested, semi‐structured questionnaire (Cronbach's α = 0.71–0.83). Primary outcomes were awareness, preventive practices, and self‐reported health symptoms within the past 12 months. Associations were examined using chi‐square tests, and determinants were assessed using multivariable logistic regression (AOR, 95% CI; p < 0.05). Results Urban respondents demonstrated higher adequate awareness of environmental (79.4% vs. 59.1%) and health effects (80.7% vs. 45.3%; p < 0.001) of plastic waste. Preventive practices were also more common among urban residents (waste segregation: 44.8% vs. 18.6%; recycling practice: 34.7% vs. 11.1%). Self‐reported health symptoms comprised breathing difficulty (73.7% vs. 60.1%) and eye irritation (31.4% vs. 15.6%). In multivariable models, adjusting for age, sex, income, higher education, and urban residence was independently associated with greater engagement in recycling (AOR:3.13 and 3.57, respectively) and use of biodegradable alternatives (AOR:2.63 and 1.64, respectively; p < 0.001). They were also associated with a greater likelihood of avoiding polythene use driven by low cost or lack of alternatives ( p < 0.05). Conclusion Despite higher awareness among urban and educated populations, preventive practices remain limited, reflecting a persistent awareness‐practice gap shaped by structural and contextual constraints. Strengthening waste management infrastructure, regulating informal burning, and improving access to affordable alternatives are essential to mitigate plastic‐related environmental and health risks in Bangladesh.