Introduction: Tobacco use is a global escalating public health problem, especially in low-incomerncountries, one-third of the adult males. Non-communicable diseases (NCDs) are a growing problem inrnAfrica and it is partially caused by tobacco use. There are few studies of smoking practices and otherrncardiovascular risk factors in Ethiopia and it is unclear how prevalent many of these problems are,rnbecause their prevalence varies in different areas of the country. A more recently survey of smokingrnprevalence in 187 countries showed that global smoking prevalence fell from 41% in 1980 to 31% inrn2012, and that Ethiopia ranks in the bottom five countries with the lowest smoking prevalence (belowrn10%), but there is evidence that smoking prevalence is increasing in Ethiopia.rnObjective: To assess active tobacco and passive smoking, for further screening of major cardiovascularrnrisk factors (serum cholesterol levels, hypertension, fasting blood glucose, Body Mass Index and waistrncircumference) among residents of Ogolcho town, Oromia; and to examine carbon monoxide levels inrnhomes in Ogolcho town.rnMethods:Across-sectional study was conducted on tobacco users, passive smokers and non-smokers in arnrural population of Ethiopia in Ogolcho, from May 2014â€“ May 2015.Subjects were interviewed, using arnstandardized WHO questionnaire, about their lifestyle habits and substance use. Blood specimens fromrnindividuals over 18 years old were taken for serum lipid profile and blood glucose levels. Urine wasrnscreened for cotinine (a nicotine metabolite) in active and passive smokers, using a One Step cotinine testrnthat detects urine cotinine levels above 200 ng/mL.Anthropometric indices (BMI, waist circumference)rnand blood pressure were measured. Frequencies ofthe different variables were analyzed statistically.rnResults: Of 95 total participants, 33% (31) were active smokers, 56.3% (54) were passive smokers, 8.6%rn(8) were neither active nor passive smokers, and 2% (2) were purely shisha smokers. Over 80% of activernand passive smokers chewed khat regularly, whereas about a half of smokers and non-smokers usedrnalcohol. All active smokers smoked either in their house or in public places, where exposure of manyrnnonsmokers, especially children and women, occurs. A high percentage of smokers smoked at homern(41%), and passive smokers that were strongly positive for urine cotinine included two children aged 4rnand 5. Of 85 passive and active smokers, 67 % (57) were positive for urine cotinine. Almost all (90%)rnactive smokers, and 54% of passive smokers, were positive for urine cotinine. Cardiovascular risk factorsrnother than smoking were common in the population studied. Active smokers had 25.8% prevalence ofrnabdominal obesity, 48.4% were underweight, 3.2% overweight, 54.8% had elevated triglycerides, 42%rnwere hypertensive, 48.4% had low HDL and 3.2% high fasting glucose. 10.3% of passive smokers hadrnabdominal obesity, 17% were underweight, 24% overweight, 55% hypertensive, 38 % had elevatedrntriglycerides and 24% had low HDL. Prevalence of CVD risk factors among non-smokers were: 12.5%rnelevated blood pressure, 50% abdominal obesity, 12.5% overweight and 37.5% overweigh. Non- smokerrnlipid profile prevalence was: elevated total cholesterol in 37.5% of subjects and decreased HDL levelrnprevalence in 25% of non-smokers. Carbon monoxide levels were generally safe in homes, except withinrncentimeter distances of charcoal stoves.rnConclusion: This cross-sectional analysis indicates that khat and alcohol consumption, or both combined,rnare common among smokers and non-smokers in Ogolcho, and the prevalence of passive smoking is high.rnUrine cotinine testing was an effective way of studying passive and active exposure to cigarette smoke.rnThe prevalence of CVD risk factors was high in the studied population, strongly supporting thernimportance of screening, prevention and treatment of smoking and other cardiovascular risk factors inrnEthiopia.