BackgroundCigarette smoking and particulate matter (PM) with aerodynamic diameter Q3, corresponding to PM2.5 ≤ 27.137, 27.137 38.205 μg/m3.ResultsThe prevalence of MS was significantly different according to PM2.5 exposure (p-value = 0.0280) and cigarette smoking (p-value 38.205 μg/m3, respectively. The risk of MS was significantly higher among former and current smokers with OR; 95% CI = 1.062; 1.008–1.118 and 1.531; 1.450–1.616, respectively, and a dose-dependent p-value 38.205 μg/m3, respectively. According to PM2.5 quartiles, current smokers had a higher risk of MS, regardless of PM2.5 levels (OR); 95% CI = 1.605; 1.444–1.785, 1.561; 1.409–1.728, 1.359; 1.211–1.524, and 1.585; 1.418–1.772 for PM2.5 ≤ 27.137, 27.137 38.205 μg/m3, respectively. After combining both exposures, the group, current smokers; PM2.5 > 38.205 μg/m3 had the highest odds (1.801; 95% CI =1.625–1.995).ConclusionPM2.5 and cigarette smoking were independently and jointly associated with a higher risk of MS. Stratified analyses revealed that cigarette smoking might have a much higher effect on MS than PM2.5. Nonetheless, exposure to both PM2.5 and cigarette smoking could compound the risk of MS.