Types of products used

• 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.
• 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.

As with the adult population, the traditional cigarette remains the tobacco product most often used by young people, independently of whether one considers electronic cigarettes, heated tobacco products (HTP), or other so-called smokeless tobacco products (for a detailed description of these different products, see our page Products). Nevertheless, the water pipe appears to be an increasingly popular way in which young people (children, adolescents, and young adults) use tobacco.

Types of products used by 14 and 15-year-old smokers

The Health Behaviour in School-aged Children[1] (HBSC) documents tobacco use among school-age children essentially in terms of cigarettes (the majority of questions about tobacco use mention “traditional cigarettes” in their wording), so the figures presented in the section entitled The prevalence of smoking among 11 to 15 year-olds can be consulted as a complement to the following description of the types of products used.

The HBSC study from 2018 also documents, however (as a complement to questions about “traditional cigarettes”), the prevalence (lifetime and in the previous 30 days) of use of a water pipe, of snus, of an electronic cigarette, or a heated tobacco product (HTP) for students ages 14 and 15 (Delgrane et al., 2019a[2]). According to this study, at the age of 14 almost one boy in five – 18.7% – and one girl in 10 – 10.7% – reported having smoked a water pipe at least once. Use of a water pipe in the previous 30 days was reported by 8.7% of boys and 4.9% of girls 14 years old. At the age of 15, almost one boy in three – 31.7% and one girl in six – 16.5% – reported having smoked a water pipe at least once in their lifetime, and 14.2% of boys and 8.0% of girls had smoked it in the previous 30 days. As for snus, the figures were 8.0% of boys and 2.6% of girls at age 14 and 13.1% (boys) and 4.8% (girls) at age 15. Use of snus in the 30 days preceding the study was reported by 3.9% of boys and less than 0.7% of girls at age 14, and 6.0% of boys and 1.3% of girls at age 15.

Types of products used by smokers ages 15 to 25

The data from the Swiss health survey (ESS, Enquête Suisse sur la santé) from 2017 regarding the types of products used were not broken down by age, thus the only observation available about the use of other tobacco products that can be gathered from this study is that while the use of water pipes was as high as 7.3% for all smokers 15 and up, more than a third – 35% – of male smokers ages 15 to 24 were using it (OFS, 2020[3]). This observation parallels one of the observations from the analysis of tobacco use by 15 to 24-year-olds from the 2016 Monitorage Suisse des addictions (Kuendig et al., 2017a[4]). For example, these analyses highlight the popularity of water pipes among young (minor) smokers. In fact, no less than 39.9% of occasional smokers and 24.9% of daily smokers 15 to 17 years old reported smoking a water pipe (46.1% and 21.8% respectively at 18 to 19 years old). It should also be noted that the data collected on this subject in the Monitorage Suisse des addictions also revealed a not-insignificant proportion – 22.3% – of non-smokers ages 15 to 25 (ex-smokers and those who had never smoked) reported having smoked a water pipe in the 12 months preceding the study.

In-depth analyses of the Monitorage Suisse des addictions also show that in 2016 almost all of 15 to 25- year-old smokers were smoking cigarettes – 99.6% of daily smokers and 90.9% of occasional smokers – and that the great majority used cigarettes only – 80.7% of daily smokers and 65.3% of occasional smokers. The use of cigars, cigarillos, or pipes appears to be rare in this age group, whether among daily or occasional smokers (the latter showing nonetheless a slightly higher use of cigars – 5.4% – and cigarillos – 7.7%). Also in this age group, a 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 used only hand-rolled cigarettes).

Oral tobacco use

The most recent data concerning the use of oral tobacco products or nasal ones (inhaled) come from the Omnibus “Santé et lifestyle”[5] questionnaire, an on-line study conducted in 2018 for the Office federal de la santé publique (OFSP). According to this study, 10.9% of 15 to 19-year-olds and 8.5% of 20 to 24- year-olds used this type of product (OBSAN, 2021[6]). Among the products examined in this study, the use of inhaled tobacco – used by 8.5% of 15 to 19-year-olds and 5.5% of 20 to 24-year-olds – surpassed that of snus – used by 2.8% of 15 to 19-year-olds and 4.2% of 20 to 24-year-olds. The use of chewing tobacco is virtually non-existent in these age groups – 1.0% of 15 to 19-year-olds use it, and 0.0% of 20 to 24-year-olds. As for snus, based on the Monitorage Suisse des addictions, the proportion of users reached 2.3% among 15 to 25-year-olds (Kuendig et al., 2017a[7]). In this age group, this type of use was more typical of men – 4.2% of users – and of German-speaking Swiss – 3.3%. At the time of these studies, in 2016 (Monitorage Suisse des addictions) and in 2018 (the Omnibus “Santé et lifestyle” study), snus was not yet for sale legally in Switzerland. It has been legal since May 2019 (as is the sale of nicotine packets). It can thus reasonably be expected that its use will increase in future studies.

ENDS: a still-emerging phenomenon

As it did for other tobacco products, the 2018 HBSC study documented, for students 14 and 15 years old, the lifetime and 30-day prevalence of use for e-cigarettes (ENDS; also called “vaporettes” in this study). At 14, more than four out of 10 boys – 42.0% – and almost three in 10 girls – 27.5% – reported having already tried ENDS at least once. Use over the past 30 days was reported by 18.4% of boys and 12.5% of girls in this age group. At 15, over half of boys – 50.9% – and more than one girl in three – 34.8% – reported having used ENDS at least once. During the 30 days prior to the study, 20.6% of boys and 12.9% of girls reported use. A small but not insignificant percentage of 15-year-olds – 3.7% of all boys and 1.2% of girls at this age – reported having smoked ENDS at least 10 days out of the 30 prior to the study. This study also documented the reasons for using electronic cigarettes. Among young people 14 and 15 years old who had used ENDS at least once, over 87% mentioned curiosity as their reason for trying it.

For youth and young adults, complementary analyses of the data from the 2017 ESS were performed in the context of the Rapport national sur la santé 2020, which examined the 16 to 25-year-old age group as a whole (Observatoire Suisse de la santé, 2020[8]). This showed that 3.3% of young men and 1.2% of young women in this age group were using ENDS occasionally or daily.

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 (Kurnedig et al., 2017b[9]). 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[10]), as compared to 33.0% (15 to 19-year-olds) and 30.1% (20 to 24-year-olds) in 2016 (Kuendig et al., 2016[11]).

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[12] 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[13]).

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., 2019a[14]; 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[15]). 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[16]; Table 4.1b).

[1] https://www.hbsc.ch; accessed 12.02.2022.

[2] 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.

[3] OFS (2020) : Actualité OFS - Enquête suisse sur la santé 2017 – Consommation de tabac en suisse. OFS. Neuchâtel. Download.

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

[5] https://www.bag.admin.ch/bag/fr/home/das-bag/ressortforschung-evaluation/forschung-im-bag/forschung-nichtuebertragbare-krankheiten/monitoring-systemncd/erhebung-gesundheit-lifestyle.html; accessed 03.02.2022.

[6] https://ind.obsan.admin.ch/fr/indicator/monam/tabac-produits-sans-fumee-age-15; accessed 12.02.2022.

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

[8] 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.

[9] Kuendig, Hervé ; Notari, Luca ; Gmel, Gerhard (2017b) : Cigarette électronique et autres produits du tabac de nouvelle génération en Suisse en 2016 - Analyse des données du Monitorage suisse des addictions. Addiction Suisse. Lausanne. Download.

[10] Kuendig, Hervé ; Notari, Luca ; Gmel, Gerhard (2014) : La cigarette électronique en Suisse en 2013 - Analyse des données du Monitorage suisse des addictions. Addiction Suisse. Lausanne. Download.

[11] Kuendig, Hervé ; Notari, Luca ; Gmel, Gerhard (2016) : La cigarette électronique e en Suisse en 2015 - Analyse des données du Monitorage suisse des addictions. Addiction Suisse. Lausanne. Download.

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

[13] 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.

[14] 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.

[15] 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.

[16] Kuendig, Hervé ; Notari, Luca ; Gmel, Gerhard (2017b) : Cigarette électronique et autres produits du tabac de nouvelle génération en Suisse en 2016 - Analyse des données du Monitorage suisse des addictions. Addiction Suisse. Lausanne. Download.

AT Switzerland, September 2022