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.
- Approximately 45% of young people ages 18 to 24 consume tobacco products and/or similar products (e.g. e-cigarettes, snus, nicotine pouches).
TOBACCO USE AMONGST THE YOUNG
Products containing tobacco and nicotine have significant effects on the behavioural and cognitive well-being of consumers and in particular young people – children, adolescents or young adults – should refrain from consuming them. Indeed, the maturation process of certain areas of the brain that are vulnerable to the neurotoxic effects of psychotropic drugs only ends around the age of 25, making children, adolescents and young adults more vulnerable to certain effects of smoking, including addiction[1]. Related to this, the risk of many consequences of smoking increases, sometimes even exponentially, with the intensity of tobacco consumption. This can be seen as the combination of two distinct dimensions, one temporal (e.g. in number of years of consumption), the other quantitative (e.g. the number of cigarettes smoked). The age of onset of consumption, and in particular early initiation, is therefore directly associated with the risk of occurrence of health problems due to smoking[2]. Monitoring the evolution of tobacco use amongst young people therefore represents a major public health issue.
Monitoring in Switzerland
In Switzerland, monitoring of tobacco use amongst young people is based mainly on data collected as part of the Health Behaviour in School-aged Children survey (HBSC)[3] and the Swiss Health Survey (ESS)[4]. The first, conducted every four years since 1986 amongst schoolchildren, documents the extent of smoking amongst 11- to 15-year-olds, the second amongst 15- to 25-year-olds. Details of these surveys are available on our page, Overview of Monitoring Tools. Data from the Swiss Tobacco Monitoring System (TMS)[5] and the CoRolAR survey of the Swiss Monitoring of Addictions[6], successively active annually until 2016, as well as the omnibus survey, “Health and Lifestyle”[7] of the Federal Office of Public Health (OFSP) permits us to complete our description. It is however necessary to recall that the data from the first two surveys cited – HBSC and ESS – do not document the evolution of tobacco use on a continuous basis (HBSC assesses every four years; ESS assesses every five years) and they also suffer from almost systematic obsolescence due to the fact that the resulting estimates are only available one to two years after data collection. Furthermore, these two surveys fail to give a very significant place to tobacco use, since they address health behaviours in the broad sense (as a result, relatively few questions relating to tobacco use can be included).
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., 2023[8]). 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 (Delgrande et al., 2023[9]).
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., 2019[10]). 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[11]) 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[12]).
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 (OFS, 2018[13]). 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[14]). 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 23 year-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[15]).
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[16] shows that 6.1% overall of this age group were smoking daily (Frey and Friemel, 2021[17]). 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 (YASS)[18], 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, 2022[19]).
Nearly half of young people ages 18 to 24 consume tobacco and/or similar products
The 2023 omnibus survey, “Health and Lifestyle”[20], an online survey conducted by the Federal Statistical Office (OFS) on behalf of the Federal Office of Public Health (OFSP) offers an even more prominent image. In this survey, it is estimated that the overall prevalence of consumption of tobacco or similar products (at least one of these products: cigarettes, e-cigarettes with or without nicotine, heated tobacco, water pipe, cigars, cigarillos, pipe, snus, nicotine pouches, chewing tobacco or snuff) was 44.8% for the 18 to 24 age group; an overall prevalence higher than that recorded in the other age groups considered (OFSP, 2024[21]). Note that although lower, this “overall” prevalence was already 23.3% among 15- to 17-year-olds.
[1] Swiss Health Observatory (2020). Health in Switzerland – Children, adolescents and young adults. National health report 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.
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[8] Delgrande Jordan, Marina; Balsiger, Nora; Schmidhauser, Valentine. (2023). Consommation de substances psychoactives chez les 11 à 15 ans en Suisse - Situation en 2022 et évolution dans le temps - Résultats de l'étude Health Behaviour in School-aged Children (HBSC) (Rapport de recherche No 149). Lausanne: Addiction Suisse. Download.
[9] Delgrande Jordan, Marina ; Balsiger, Nora; Schmidhauser, Valentine. (2023). Consommation de substances psychoactives chez les 11 à 15 ans en Suisse - Situation en 2022 et évolution dans le temps - Résultats de l'étude Health Behaviour in School-aged Children (HBSC) (Rapport de recherche No 149). Lausanne: Addiction Suisse. Download.
[10] Delgrande Jordan, Marina; Eichenberger, Yvonne; Kretschmann, Andrea; Schneider, Eva. (2019). Eine explorative Untersuchung des Zusammenhangs 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.
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[12] 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.
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[16] https://www.ikmz.uzh.ch/de/research/divisions/media-use-and-effects/projects/Gesundheitsverhalten-Jugendliche.html; accédé le 12.02.2022.
[17] 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.
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AT Switzerland, February 2025