Overview of monitoring tools

At present, systematic monitoring of smoking in Switzerland relies almost entirely on data collected through two nationally representative studies: the Swiss Health Survey[1] (SHS), covering the population aged 15 and over, and the Health Behaviour in School-aged Children[2] (HBSC) study, covering school pupils aged 11-15. These surveys are the principal data sources used to define the smoking indicators in the Federal Office of Public Health's (FOPH) Addiction and NCD Monitoring System (MonAM; Obsan, 2026[3]). As these indicators cover some key dimensions of smoking behaviour only partially — such as levels of consumption and new products — they are supplemented by indicators from data sources with a range of methodological foundations. In general, these are not monitoring tools in their own right, such as online omnibus surveys and secondary analyses of surveys that address smoking indirectly. One example is the Health and Lifestyle Survey, a collaboration between the Federal Office of Public Health, the Tobacco Prevention Fund, and the Federal Statistical Office[4]. Other sources are not ideally aligned for monitoring purposes because, for example, they lack compatible definitions and measurement tools or involve major methodological variations.

In other words, it is highly regrettable that monitoring of smoking in Switzerland currently relies on a very limited number of ad hoc indicators, supplemented by heterogeneous indicators of lower quality. To compensate partially for the shortage of high-quality data, the epidemiological overview on our website draws in part on older but relatively detailed data from Tobacco Monitoring Switzerland, conducted from 2001 to 2010, and the CoRolAR survey from Swiss Addiction Monitoring[5], conducted from 2011 to 2016. A summary table of the surveys included in our epidemiological overview is provided at the bottom of the page.

Shortage of monitoring tools in Switzerland

From the perspective of monitoring smoking behaviour, data from the Swiss Health Survey and the Health Behaviour in School-aged Children study are not without limitations. The SHS has been conducted since 1992, but only every five years, making it impossible to track smoking trends in Switzerland continuously. HBSC has the same limitation, as it has been conducted every four years since 1986. The frequency of these surveys and the extensive logistics involved mean that the resulting estimates are almost invariably out of date. Detailed estimates are not published until one to two years after data collection, and then remain the reference figures until the next survey wave is published. For example, detailed prevalence estimates from the 2022 SHS were published in 2024 and are likely to remain the reference until 2029 or even 2030. The logistics of both surveys also require questionnaires to be finalised far in advance, limiting their responsiveness to emerging phenomena. This is especially problematic in a rapidly changing environment such as that of 'new tobacco products', where products have appeared and replaced one another in quick succession for more than a decade. Current monitoring tools are therefore very limited in their ability to fulfil their role as an early-warning and tracking system for emerging phenomena. More frequent omnibus surveys such as the Health and Lifestyle Survey[4], which is largely devoted to smoking-related issues, aim to address these shortcomings. However, because such a study is not designed specifically for epidemiological monitoring, it can only partially overcome this limitation.

1. University Institute of Social and Preventive Medicine

2. Swiss Research Institute for Public Health and Addiction

3. Institute for Accompanying and Social Research

Another important limitation on comprehensive investigation of smoking is that these two surveys collect only a limited amount of data on the subject because they cover a broad range of health topics. Both the Swiss Health Survey and the Health Behaviour in School-aged Children study address health behaviour in general and cannot devote substantial space to smoking. They therefore include only a small number of questions specifically on the subject. This lack of space also makes it impossible to document current smoking-related phenomena and their evolution over time comprehensively.

Potentially even more problematic, the relatively long interval between SHS and HBSC measurements creates difficulties in interpreting changes in the available estimates. In particular, it is unclear whether variations between survey waves reflect genuine trends or temporary fluctuations, for example those influenced by the particular context of a given survey year. As a result, trends suggested by the latest published findings cannot be confirmed or disproved until four or five years later.

Combined with the long interval between data collections, the limited space in these surveys also makes it impossible to respond quickly and adapt survey tools to short-term changes in smoking, such as new trends or products. For the same reasons, related topics such as smoking cessation or exposure of the population — particularly young people — to marketing cannot be covered. The surveys' need to provide a consistent historical monitoring function also means that they must retain measurement tools used in earlier waves. This reduces the scope in both surveys to adapt items or add new ones relating to other smoking-related phenomena, including new products and other 'traditional' tobacco products. For example, HBSC examines smoking among 11 to 15-year-olds primarily through the lens of cigarette use. Its few items on other tobacco products are secondary to the core questions on cigarette use.

Many of the limitations affecting SHS and HBSC — including the frequency of data collection, estimates becoming outdated, incomplete coverage of smoking-related phenomena, limited responsiveness to emerging phenomena, and inability to cover related topics — were avoided in the past by conducting surveys dedicated to smoking. These included Tobacco Monitoring Switzerland (TMS), followed by the CoRolAR survey from Swiss Addiction Monitoring[5], in which smoking was covered extensively through oversampling and modular questionnaires dedicated to the subject.

Regular surveys as a priority

Given the weaknesses of Switzerland's current system for monitoring smoking behaviour and the limitations of the principal surveys on which it relies, resuming regular measurements using survey tools specifically designed to document smoking and related topics should be a priority. Related topics include cessation, the influence of the social and economic environment, and individual socioeconomic circumstances. These regular measurements should be capable of identifying and tracking future phenomena and trends even when they cannot yet be anticipated, whether they concern new tobacco products or new ways of using products such as CBD and cannabis, which are frequently consumed in combination with tobacco. Relaunching a survey like those conducted between 2001 and 2016 through Tobacco Monitoring Switzerland and then Swiss Addiction Monitoring, combined with the systematic and continuous collection of data on the sale and marketing of tobacco products, new-generation devices, and the products that will inevitably replace them in future — as well as, for example, nicotine-replacement products and other aspects of cessation — would make it possible to establish a genuine epidemiological monitoring system for smoking in Switzerland. It is also essential to understand how and where young people buy the products they use. With the rapid growth of online sales, particularly during the COVID-19 pandemic, purchasing patterns and access to products have changed, especially among young people. Young people's access to tobacco products should therefore be investigated specifically, particularly following the entry into force of the Tobacco Products Act in 2024, which introduced a nationwide ban on sales to minors. Monitoring and enforcement should consequently also cover online purchases.

Given how smoking develops in Switzerland — with behaviours emerging and becoming established mainly in the youngest age groups — and the marked shortage of detailed data that can be analysed by age subgroup, particularly among the youngest people, continuous monitoring through an annual survey appears essential for adolescents and young adults. By contrast, older people could be surveyed every two years.

An ideal monitoring system

In summary, a dedicated system in Switzerland for monitoring smoking would ideally combine indicators collected in real time, such as sales or service-use data, with epidemiological estimates produced rapidly and published continuously, particularly for population subgroups most affected by smoking and emerging phenomena. It should also be compatible with the World Health Organization's monitoring model[6], based on a clear theoretical framework[7] and explicitly defined surveillance criteria[8]. This is not currently the case in Switzerland.

In conclusion, the shortcomings of Switzerland's monitoring system are not confined to tobacco. They also affect other psychoactive substances and addiction-related behaviours. Without a high-quality monitoring system, public health and prevention policies on smoking cannot be managed effectively. Such a system inevitably carries a cost, although this can now be reduced through greater use of new technologies. We believe that Switzerland has the resources to establish such a system for all addictions, but particularly for smoking, which accounts for half of all addiction-related social costs in the country.

[1] https://www.bfs.admin.ch/bfs/fr/home/statistiques/sante/enquetes/sgb.html ; consulted on 30.04.2026.

[2] https://www.hbsc.ch; consulted on 30.04.2026.

[3] https://ind.obsan.admin.ch/fr/monam/topic/1TAB; consulted on 30.04.2026.

[4] https://www.bag.admin.ch/fr/enquete-sante-et-lifestyle; consulted on 30.04.2026.

[5] https://www.suchtmonitoring.ch/fr/page/8.html; consulted on 30.04.2026.

[6] https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/tobacco-surveillance; consulted on 30.04.2026.

[7] voir par ex. Groseclose, Samuel L.; Buckeridge, David L. (2017): Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation. In Annual review of public health 38:57–79.

[8] Drewe, J. A.; Hoinville, L. J.; Cook, A. J. C.; Floyd, T.; Stärk, K. D. C. (2012): Evaluation of animal and public health surveillance systems: a systematic review. In Epidemiology and infection 140:575–590.

AT Switzerland, April 2026