Types of products consumed

• Traditional cigarettes remain the most commonly used form of tobacco for 15 to 25-year-olds. However, water pipe use also represents a not insignificant proportion of tobacco use among young people.
• More than one boy out of three (31.7%) and one girl out of six (16.5%) has already used a water pipe at least once.
• More than one boy in eight (13.1%) and one girl in 20 (4.8%) has tried snus.
• At 15, more than half of boys (50.9%) and more than one-third of girls (34.8%) have tried ENDS at least once. In addition, a not insignificant number of young people this age – 3.7% of all boys and 1.2% of girls – reported having used ENDS at least 10 out of the preceding 30 days.
• In 2018, when this type of product had only recently arrived on the market in Switzerland, 2.2% of boys and 1.2% of girls age 15 had already tried a Heated Tobacco Product (HTP) at least once; two years previously, in 2016, 2.2% of 15 to 19-year-olds and 4.9% of 20 to 24-year-olds had tried them.

As with the adult population, traditional cigarettes remain the tobacco product most consumed by young people, regardless of whether or not they consider the e-cigarettes (Electronic Nicotine Delivery Systems or ENDS), heated tobacco products (HTP) or other so-called smokeless tobacco products (for a detailed description of these different products, see our page, Products). However, water pipe smoking seems to be taking an increasingly important place in youth smoking (children, adolescents and young adults).

Types of products consumed by smokers ages 14 to15

The survey, Health Behaviour in School-aged Children (HBSC)[22], mainly documenting smoking phenomena among schoolchildren from the perspective of cigarettes (the majority of smoking-related questions specifically mention “traditional cigarettes” in their statements), the figures presented in the section, Prevalence of Smoking Amongst 11- to 15-year-olds, can be consulted in addition to the description below concerning the types of products consumed.

The 2022 HBSC survey also (in addition to the questions on “traditional cigarettes”) documented, for schoolchildren ages 11 to 15, the lifetime and 30-day prevalence of  e-cigarette use (ENDS; on this subject see the detailed description below) and, for 14- and 15-year-olds, the lifetime and 30-day prevalence of water pipe, snus, snuff and heated tobacco product (HTP) use (Delgrande et al., 2023[23]). In this survey, at the age of 15, almost one in five boys – 17.9% – and one in 10 girls – 10.2% – said they had smoked a water pipe at least once in their life[24]. Consumption in the last 30 days was reported by 14.2% of boys and 8.0% of girls, still at the age of 15[25]. At age 14, 8.7% (boys) and 4.9% (girls) had used one in the previous 30 days. The lifetime prevalence of snus use reached 13.2% in boys and 8.8% in girls at the age of 14 and respectively 23.7% (boys) and 12.2% (girls) at the age of 15[26]. Consumption during the 30 days preceding the survey concerned 6.8% of 14-year-old boys, 4.2% of 14-year-old girls, 12.8% of 15-year-old boys and 5.6% of 15-year-old girls[27]. It should be noted that all figures concerning snus consumption increased significantly between 2018 and 2022. For example, in 2018, the proportion of 14- and 15-year-old girls who had used snus in the previous 30 days was 0.7% (14-year-olds) and 1.3% (15-year-olds) respectively. The consumption of snuff tobacco also was not negligible in these age groups: more than one in 10 young people – 10.3% – age 15 had used snuff in the 30 days preceding the 2022 survey[28]. In terms of lifetime prevalence, this reached 21.7% at 15 years and 14.2% at 14 years[29].

Types of products consumed by people ages 15 to 25

The data from the 2022 Swiss Health Survey (ESS) on the types of products consumed was detailed by age, thus this survey shows that for 15- to 25-year-olds, cigarettes are the most consumed tobacco product: 22.9% of young people – 23.3% females et 22.5% males – in this age group consume cigarettes (OFS, 2024a[1] et 2024b). Tobacco consumption in the form of snus – 7.2%; 2.8% of females and 11.2% of males – and water pipe – 6.6%; 5.3% of females and 7.8% of males – was however relatively frequent at these ages, as was the use of e-cigarettes – 5.3%; 5.6% of females and 5.1% of males[30]. These observations echo one of the findings made during analyses specifically targeting 15- to 25-year-olds, based on 2016 data from the Swiss Addiction Monitoring Survey (Kuendig et al., 2017a[31]). These analyses highlighted, for example, the great popularity of the water pipe amongst underage smokers. Indeed, no less than 39.9% of occasional smokers and 24.9% of daily smokers ages 15 to 17 reported smoking a water pipe (respectively 46.1% and 21.8% of 18- to 19-year-olds). It should also be noted that the data collected on this subject as part of the Swiss Addiction Monitoring also highlighted that a significant proportion – 22.3% – of non-smokers ages 15 to 25 (ex-smokers and never smokers) reported having smoked a water pipe in the 12 months preceding their participation in the survey. Further data on water pipe smoking were collected as part of the FOPH’s 2023 omnibus “Health and Lifestyle” survey[32]. In the context of this survey, while 3.0% of the population ages 15 and older had smoked a water pipe in the previous 12 months, this same prevalence of use reached 9.9% amongst young people ages 15 to 24 (OFSP, 2024[33]).

In-depth analyses by the Swiss Addiction Monitoring also reveal that in 2016 almost all smokers ages 15 to 25 consumed cigarettes – 99.6% of daily smokers and 90.9% of occasional smokers – and that a large majority consumed only cigarettes – 80.7% of daily smokers and 65.3% of occasional smokers. The consumption of cigars, cigarillos or pipes appears to be very uncommon in this age group, whether among daily or occasional smokers (the latter, however, having a slightly higher share of cigar smokers – 5.4% – and cigarillo smokers – 7.7%). It should also be noted that in this age group, approximately one-third of cigarette smokers – 36.2% of daily smokers and 30.8% of occasional smokers – smoked hand-rolled cigarettes (among cigarette smokers, 13.0% of daily smokers and 7.7% of occasional smokers smoked only hand-rolled cigarettes).

Products consumed orally

As already mentioned above, the 2022 Swiss Health Survey (ESS) highlights the importance of snus consumption amongst 15- to 24-year-olds (OFS, 2024[34]). Thus, according to this data source, snus was consumed by 11.2% of males in this age group. Females were 2.8% to report such use, for a total prevalence of 7.2% for all 15- to 24-year-olds.

Other recent data on the use of oral or nasal tobacco products (snuff) are available via the 2023 omnibus “Health and Lifestyle” survey[35]. In this online survey conducted by the OFS on behalf of OFSP, 7.9% of 15- to 24-year-olds reported using snuff and 7.7% snus (OBSAN, 2023[36]). Concerning snus, based on the Swiss Addiction Monitoring, the consumer share reached 2.3% in 2016 amongst 15- to 25-year-olds (Kuendig et al., 2017a[37]). In this age group, this type of consumption concerned in particular males – 4.2% of consumers – and German-speaking Swiss – 3.3%. It should be noted that at the time of these measurements, in 2016, snus was not yet authorised for sale in Switzerland. It has been authorised since May 2019 (as are nicotine pouches). It was therefore reasonably expected that its use would increase in the context of new surveys.

ENDS: a still-emerging phenomenon

The 2022 HBSC survey[38] documented for the first time for schoolchildren ages 11 to 15 the lifetime and 30-day prevalence of e-cigarette use (ENDS; also called “vaporette” in the context of this survey). The prevalence of experimentation, or lifetime use, of e-cigarettes reached 4.0% at age 11, 9.2% at age 12, 19.6% at age 13, 32.6% at age 14, and 41.9% at age 15. These prevalence for each age were slightly higher in boys than in girls. The use of e-cigarettes during the previous 30 days was reported by 1.6% of 11-year-old schoolchildren (2.2% of boys and 1.1% of girls this age) and 3.1% of 12-year-old schoolchildren (3.1% of boys and 2.8% of girls). The percentage then increased very sharply with age: more than one in 10 young people – 10.3% – age 13, more than one in six – 17.3% – age 14 and more than one in four – 25.1% – age 15 had used an e-cigarette in the previous 30 days. It should be noted that a significant proportion of young people ages 14 to 15 reported having consumed ENDS on 10 or more days in the 30 days preceding the survey: at the age of 14, that was the case with nearly one in 20 schoolchildren – 4.7% – and one in 14 – 7.1% – at the age of 15. This survey also documented the reasons for using e-cigarettes. Amongst young people ages 14 to 15 who had used ENDS at least once in their lives, a very large majority (over 90%) cited curiosity as a reason for consumption; about one in two (48.8% at age 14, 57.5% at age 15) reported doing it “because I like it”; between one in 10 (10.1% of 14-year-olds) and one in six (15.0% of 15-year-olds) “to smoke fewer cigarettes” and between one in 14 (7.0% of 14-year-olds) and one in 10 (10.7% of 15-year-olds) “to help me stop smoking”.

Note that data on the evolution of the prevalence of lifelong ENDS use[39] and at 30 days[40] are available for 14- and 15-year-old schoolchildren as part of this project: for example, compared to 2018, the use of ENDS at least 10 days out of the last 30 appears to have increased sharply by the age of 15 in 2022, both amongst boys (from 3.7% to 6.7%) and girls (from 1.2% to 7.5%; these increases being statistically significant in both cases[41]).

At the level of youth and young adults, additional analyses on the 2017 ESS data were carried out as part of the 2020 National Health Report, which considered 16- to 25-year-olds together (Swiss Health Observatory, 2020[42]). It appears that 3.3% of young males and 1.2% of young females in this age group used ENDS occasionally or daily in 2017.

Figures from the 2022 Swiss Health Survey (ESS) relating to the use of ENDS were also published by the Federal Statistical Office (OFS) on the occasion of the publication of the consumption prevalence figures (OFS, 2023[43]) then thematic analyses (OFS, 2024b). It thus appears that in 2022, according to this survey, while 2.8% of the population ages 15 and older used e-cigarettes, this share reached 5.1% amongst males and 5.6% amongst females ages 15 to 24 respectively. These figures are significantly higher than those of 2017. The omnibus “Health and Lifestyle” survey[44] of the Federal Office of Public Health (OFSP) also documented the use of e-cigarettes. In the context of this survey, it is estimated that in 2023 the prevalence of use over the previous 12 months reached 16.0% amongst 15- to 24-year-olds (14.4% in the 15 to 17 age group and 16.7% amongst 18- to 24-year-olds, compared to a maximum of around 8% in the other age groups considered; OFSP, 2024[45]).

The data from the CoRolAR 2016 study from the Monitorage Suisse des addictions allow us to refine our epidemiological description of the use of ENDS among young adults (Kuendig et al., 2017b[46]). According to this study, while those under 25 were, in 2016, most likely to experiment with this type of product (32.7% of 15 to 29-year-olds and 32.9% of 20 to 24-year-olds had tried them at least once), relatively few of them were regular users. In fact, less than 1% of 15 to 19-year-olds and of 20 to 24-year-olds reported using them weekly or more. Regarding the evolution of this type of use, the data from the Monitorage Suisse des addictions underline, across measures from three points in time (2013, 2015, and 2016), a rapid increase in experimentation with this type of product. In 2013, only 15.8% of 15 to 19- year-olds and 16.1% of 20 to 24-year-olds had tried ENDS in their lifetime (Kuendig et al., 2014[47]), as compared to 33.0% (15 to 19-year-olds) and 30.1% (20 to 24-year-olds) in 2016 (Kuendig et al., 2016[48]).

The legal framework and the market for ENDS have evolved greatly since the studies in question. In particular, the sale of nicotine-containing liquids was illegal prior to 2019 (only individuals could legally import them) and a new generation of products such as Juul (which afterward was taken off the market nationally) and Puff Bar were not yet available in Switzerland. Although it is risky to compare these numbers with those previously cited (due to major differences in the measuring instruments used), a 2021 study by the University of Zurich on the influence of the social and media environment on the health behaviours of 15 to 19-year-olds suggests that 34.4% of young people 15 to 19 years old may already have used ENDS, 6.3% may be using regularly (at least once per month), and 1.2% daily (Frey and Friemel, 2021[49]).

Heated tobacco products

The 2018 HBSC study also documented, for students 14 and 15 years old, a lifetime and a 30-day prevalence of use of heated tobacco products (HTP) (Delgrande et al., 2023[50]; Annexes 3.13 and 3.14). This study shows that in 2018, at age 15, 2.2% of boys and 1.2% of girls had used HTPs at least once (compared to 1.2% of boys and 0.7% of girls age 14). The use of HTPs over the past 30 days was, unsurprisingly, lower (0.5% of boys and 0.2% of girls at age 14; 1.3% and 0.9% respectively at 15).

Based on the data from the 2017 ESS study, the Rapport national sur la Santé 2020, on the other hand, reports that the proportion of 16 to 25-year-olds using HTPs was close to 0% (Observatoire Suisse sur la santé, 2020[51]). This estimate appears surprising, however, because the latest data coming out of the Monitorage Suisse des addictions (2016) reveal prevalences of experimentation (at least one use) of 2.2% for 15 to 19-year-olds and 4.9% for 20 to 24-year-olds, of use in the past 30 days of 0.5% of 15 to 19-year-olds and 1.3% for 20 to 24-year-olds, and of at least weekly use of 0.3% for 15 to 19-year-olds and 1.0% for 20 to 24-year-olds (Kurendig at al., 2017b[52]; Table 4.1b).

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AT Switzerland, February 2025