Tobacco use among young people

• About one-third of young people 15 years old (29.8% of girls and 35.4% of boys, respectively) have already tried cigarettes at least once in their lifetime; 5.6% of boys – one in 18 – and 3.5% of girls smoke daily at this age.
• Overall, around one-third of 15 to 25-year-olds smoke.
• The studies which are currently available precede the arrival or legal distribution of most new tobacco products, such as snus (with or without tobacco), nicotine liquids for ENDS, 4th generation ENDS (pods such as Juul for vaping), or 5th generation (Puff Bar) products on the market in Switzerland.

Tobacco use among young people

Products containing tobacco and nicotine have significant effects on the behavioural and cognitive equilibrium of users, and young people in particular – children, adolescents, or young adults – should abstain from using them. The maturation process of certain parts of the brain, which are vulnerable to the neurotoxic effects of psychotropic substances, is not finished until around 25 years of age, with the result that children, adolescents, and young adults are more vulnerable to some of the effects of smoking, such as addiction[1]. At the same time, the risk of many of the consequences of smoking increase, sometimes exponentially, according to the intensity of use. This can be seen as a combination of two distinct dimensions, one being temporal (for example number of years of tobacco use), and the other quantitative (number of cigarettes smoked). The age of starting to smoke, and in particular starting young, is directly correlated with the risk of tobacco-related health problems[2]. Thus, tracking the evolution of tobacco use among young people represents an important public health issue.

Monitoring in Switzerland

In Switzerland, the monitoring of tobacco use among young people is essentially based on data collected in the course of the study called Health Behaviour in School-Aged Children[3] (HBSC) and the Swiss health survey[4] (ESS). The first of these, which has been conducted with schoolchildren every four years since 1986, documents the extent of tobacco use with 11 to 15-year-olds, and the second with 15 to 25-year-olds. More details about these studies are available on our page Overview of monitoring instruments. Data from the Monitorage sur le tabac suisse (TMS [5]) and from the CoRolAR study from Monitorage Suisse des addictions[6], which have tracked tobacco use annually up through 2016, help us complete the picture. However, it must be remembered that the data from the first two studies cited – HBSC and ESS – do not document tobacco use on a continual basis (points in time every four years for the HBSC, every five years for the ESS) and thus suffer from a virtually systematic obsolescence due to the fact that the estimates that they report are available only two years after the data are collected. In addition, these two studies do not place a great emphasis on smoking because they are looking at health behaviours in a broad sense (and thus include relatively few questions related to smoking).

The prevalence of smoking among 11 to 15-year-olds

The most recent data regarding tobacco use among 11 to 15-year-olds come from the 2018 HBSC study (Delgrande et al., 2019a[7]). According to this study, 1.9% of girls 11 years old and 5.7% of boys that age had already experimented with cigarettes (smoking at least once in their lifetime; Figure A2A-1). These proportions increase considerably with age, such that 35.4% of boys and 29.8% of girls by the age of 15 have smoked at least once. A similar increase has been observed for the 30-day prevalence (smoking at least once during the 30 days prior to the study), although with lower thresholds: in 2018, 16.6% of boys and 15.2% of girls had smoked in the previous month. The proportion of young people having smoked in the past 30 days stayed relatively low for boys and girls 11, 12, and 13 years old, but had already begun to climb steeply by age 14 (9.5% of girls and 9.9% of boys).

Figure A2A-1 – Prevalence (%) of experimentation with tobacco (used at least once), consumption during the previous 30 days, and daily use during the previous 30 days by schoolchildren, broken down by age, HBSC 2018 (Sources Delgrane et al., 2019a[8]).

One 15-year-old boy out of 18 smokes daily

Daily tobacco use remained almost non-existent before age 14 in 2018, among boys as well as girls (Figure A2A-1). However, 1.9% of 14-year-old girls and 3.5% of 15-year-old girls were smoking daily. For boys of these ages, the proportions were 1.6% (age 14) and 5.6% (age 15). Thus in 2018, one 15-year-old boy out of 18 was smoking daily.

Significant differences as a function of life circumstances

In-depth analyses of the data from HBSC 2018 focused on the correlation between the use of psychoactive substances and various socio-demographic, family/relational, and health/well-being factors for 14 to 15-year-old students (Delgrande et al., 2019b[9]). In these analyses, smoking at least weekly was considered as high-risk behaviour. This type of tobacco consumption was correlated (the correlation being statistically significant) with age (14 years < 15 years: larger proportion of smokers at age 15 than at age 14), the region where the students live (German-speaking Switzerland < French- or Italian-speaking Switzerland), the family composition (young person living with both parents < other family compositions), the perception of parental monitoring (high level < low or moderate level), the perception of parental support (high level < low or moderate level), the level of stress about schoolwork (low stress < moderate or high stress), life satisfaction (high satisfaction < low satisfaction), perceived health of the student (good health < poor health), and the average amount of sleep before a school day (8 hours or more < less than 8 hours).

Other factors which are also potentially correlated with an early start to smoking, such as the smoking environment (smoking on the part of parents and among friends) or ethnic origin/immigration status, were not considered in these analyses. However, other complementary analyses, taken from the Rapport national sur la Santé 2020 (Observatoire Suisse de la santé, 2020[10]) and examining the 11 to 15- year-old age group, underlines the finding that weekly cigarette smoking was more widespread among 11 to 15-year-olds who had one parent who was a first-generation immigrant (more precisely, one of the parents was born in another country; 3.5%) than those whose parents were both born in Switzerland (2.1%). Regarding the impact of parental smoking, a Zurich study conducted between 2013 and 2016 with children and young people ages 6 to 17 showed that, for 13 to 17-year-olds, parental smoking (of the father or the mother) was significantly correlated with smoking of the young people (Mozun et al., 2020[11]).

The prevalence of smoking among 15 to 25-year-olds

Studies of the general population, which usually target people 15 years old and up (e.g. ESS and CoRolAR of the Monitorage Suisse des addictions) also provide information about smoking among young people and young adults.

Almost a third of adolescents and young adults smoke

In Switzerland, 31.7% of the population ages 15 to 24 years old smoke, according to the most recent epidemiological data from the Swiss health survey of 2017 (sources OFS, 2018[12]). This proportion is 34.1% for men and 29.2% for women in this age group.

Three out of 10 young adults ages 24 to 25 years old smoke daily

In-depth analyses targeting 15 to 25-year-olds were conducted during the Monitorage Suisse des addictions, based on data from the 2016 CoRolAR study (Kuendig et al., 2017[13]). In all, 31.6% of 15 to 25- year-olds, according to this study, were smokers (Figure A2A-2), representing a noticeably higher proportion than in the general population (25.3%). The proportion of smokers was 15.8% for youths 15 to 17 years old. A clear and regular progression was then observed for 18 to 19-year-olds (29.0%) and 20 to 21-year-olds (41.1%). After that age, the total proportion of smokers declines slightly (38.7% for 22 to 230year-olds, 37.6% for 24 to 25-year-olds). Nevertheless, the proportion of those who smoke daily continues to progress among 24 to 25-year-olds, reaching 30.0% (it was 7.4% at age 15 to 17, 15.5% for 18 to 19-year-olds and 26.9% and 26.0% for 20 to 21-year-olds and 22 to 23-year-olds respectively); the proportion of occasional smokes, on the other hand, diminishes after the age of 20.

Figure A2A-2 – Prevalence of smoking (%) among 15 to 25-year-olds, overall and by sex, language region, and age, CoRolAR 2016 (Kuendig et al., 2017[14]).

Out of all 15 to 25-year-olds, the proportion of smokers was 35.7% for men, compared to 27.3% for women (Figure A2A-2). This proportion was clearly higher in Italian Switzerland (40.7%) and French-speaking Switzerland (38.1%) than in the German-speaking part of the country (28.7%).

A study by the University of Zurich addressing the influence of the social and media environment on the health-related behaviour of young people ages 15 to 19[15] shows that 6.1% overall of this age group were smoking daily (Frey and Friemel, 2021[16]). However, these results cannot be compared with those of some previously cited studies (HBSC, ESS, CoRolAR), because the differences in the design of the study and in the questions asked were so different. Finally, the Young Adult Survey Switzerland[17] (YASS), conducted in 2018-2019 and focusing on the living conditions and social and political orientations of young people 18 to 21 in Switzerland, highlight interesting differences as to the distribution of smoking behaviour as a function of life circumstances in this age group. Although this study used yet another, different set of measures, which preclude direct comparison with the previous studies, it revealed that the proportion of young adults who smoke daily is noticeably higher in cities and urban areas around a downtown area than in less-urban settings (isolated cities or rural communities; Huber, Eds., 2022[18]).

[1] Observatoire Suisse de la santé (2020). La santé en Suisse – Enfants, adolescents et jeunes adultes. Rapport national sur la santé 2020. Bern: Hogrefe Verlag. Download.

[2] U.S. Department of Health and Human Services (2012). Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Download.

[3] https://www.hbsc.ch; accessed 03.02.2022.

[4] https://www.bfs.admin.ch/bfs/fr/home/statistiques/sante/enquetes/sgb.html; accessed 12.02.2022.

[5] http://www.tabakmonitoring.ch/Accueil_fr.html; accessed 12.02.2022.

[6] https://www.suchtmonitoring.ch/fr.html; accessed 12.02.2022.

[7] Delgrande Jordan, Marina ; Schneider, Eva ; Eichenberger, Yvonne ; Kretschmann, Andrea. (2019a). La consommation de substances psychoactives des 11 à 15 ans en Suisse - Situation en 2018 et évolutions depuis 1986 - Résultats de l'étude Health Behaviour in School-aged Children (HBSC) (Rapport de recherche No 100). Lausanne: Addiction Suisse. Download.

[8] Delgrande Jordan, Marina ; Schneider, Eva ; Eichenberger, Yvonne ; Kretschmann, Andrea. (2019a). La consommation de substances psychoactives des 11 à 15 ans en Suisse - Situation en 2018 et évolutions depuis 1986 - Résultats de l'étude Health Behaviour in School-aged Children (HBSC) (Rapport de recherche No 100). Lausanne: Addiction Suisse. Download.

[9] Delgrande Jordan, Marina; Eichenberger, Yvonne; Kretschmann, Andrea ; Schneider, Eva. (2019b). Eine explorative Untersuchung des Zu- sammenhangs zwischen dem Konsum psychoaktiver Substanzen und Merkmalen 11- bis 15-jähriger Jugendlicher in der Schweiz - Ergebnisse der Studie «Health Behaviour in School-aged Children» (HBSC) 2018 (Forschungsbericht No 105). Lausanne: Addiction Suisse. Download.

[10] Observatoire Suisse de la santé (2020). La santé en Suisse – Enfants, adolescents et jeunes adultes. Rapport national sur la santé 2020. Bern: Hogrefe Verlag. Download.

[11] Mozun, Rebeca; Ardura-Garcia, Cristina; Jong, Carmen C. M. de; Goutaki, Myrofora; Usemann, Jakob; Singer, Florian et al. (2020): Cigarette, shisha, and electronic smoking and respiratory symptoms in Swiss children: The LUIS study. In Pediatric pulmonology. DOI: 10.1002/ppul.24985.

[12] https://www.bfs.admin.ch/bfs/fr/home/statistiques/sante/determinants/tabac.assetdetail.6466022.html; accessed 03.02.2022.

[13] Kuendig, Hervé; Notari, Luca; Gmel, Gerhard (2017). Le tabagisme chez les 15 à 25 ans en 2016 - Analyse des données du Monitorage suisse des addictions. Lausanne : Addiction Suisse. Download.

[14] Kuendig, Hervé; Notari, Luca; Gmel, Gerhard (2017). Le tabagisme chez les 15 à 25 ans en 2016 - Analyse des données du Monitorage suisse des addictions. Lausanne : Addiction Suisse. Download.

[15] https://www.ikmz.uzh.ch/de/research/divisions/media-use-and-effects/projects/Gesundheitsverhalten-Jugendliche.html; accessed 12.02.2022.

[16] Frey, Tobias; Friemel, Thomas N. (2021). Substanzkonsum unter Jugendlichen und jungen Erwachsenen in der Schweiz im Jahr 2021. Eine repräsentative Befragung unter 15- bis 19-Jährigen. Zürich: Universität Zürich. Download.

[17] https://www.chx.ch/fr/yass, accessed le 20.03.2022.

[18] Huber, Gerhard (Eds.) (2022). Young Adult Survey Switzerland 2022 – Band 3. Bern: Office fe?de?ral des constructions et de la logistique. Download.

AT Switzerland, September 2022