A gendered acculturation risk: Tobacco and nicotine use among Ukrainian refugees in Switzerland
Abstract
Background: Smoking remains a major public health concern in Switzerland where 22.2% smoking prevalence among women (23.5% men) substantially exceeds that in Ukraine with 9.8% (35.1% for men, all 2025). Since 2022, Ukrainians represent a large and distinct refugee group, predominantly women, potentially vulnerable to acculturation-driven tobacco use increases. Switzerland’s weak tobacco control environment heightens this risk. This study examines behaviours, knowledge and attitudes towards tobacco and nicotine use among Ukrainian refugees using data from the PATHS survey.
Methods: PATHS collected data from migrants in Switzerland between May 2025 and May 2026. We conducted a descriptive analysis of Ukrainian refugees (arrived 2022 or later; n = 248; aged 15–76, IQR 32–50; 72% female; 75% tertiary education), assessing smoking prevalence and attitudes towards tobacco control. Analyses of smoking knowledge and attitudes are ongoing.
Results: Overall, 172 (69%, 66% of participating women) had ever used tobacco or nicotine products and 56 (23%, 18% of women) reported current use. Cigarettes were most common (77%; 14% of women), followed by e-cigarettes (38%; 7% of women) and heated tobacco products (25%; 6% of women). 15% (18% of women) reported no smoking among family or friends. 45% reported contact with tobacco marketing in Switzerland. Despite this, 94% (96% of women) supported a ban on smoking in public spaces.
Conclusions: Despite socio-demographic profiles typically associated with lower smoking risk, tobacco use is common alongside high marketing and social exposure. The predominantly women and younger Ukrainian refugee population faces particular acculturation risk, entering a country where smoking is less gendered and product are advertised more extensively than in Ukraine. Strong support for public smoking bans signals readiness for stricter tobacco control, including advertising restrictions and taxation, to prevent additional burden on the Swiss health system.
Key messages: • Swiss female smoking prevalence is 2.5x higher than in Ukraine — Ukrainian refugee women face significant acculturation-driven risk of increased tobacco use.
• High marketing exposure and social smoking normalisation among Ukrainian refugees in Switzerland call for stronger advertising restrictions and taxation.
Related
- Beyond coverage: reviewing barriers and facilitators to healthcare access among Ukrainian refugees
- Evaluating the effect of the MindSpring intervention on empowerment among Ukrainian refugees
- Health needs of Ukrainian war refugees in Europe and beyond: a scoping review
- Mammograms and cervical tests among Ukrainian refugees and main population: survey in Estonia, 2024
- Tobacco and nicotine products in Switzerland: a national analysis of market notifications
BibTeX
@article{krasnova2026gendered,
title = {{A gendered acculturation risk: Tobacco and nicotine use among Ukrainian refugees in Switzerland}},
author = {T Krasnova and K Schuerch and A Frahsa},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.2054},
url = {https://doi.org/10.1093/eurpub/ckag169.2054},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - A gendered acculturation risk: Tobacco and nicotine use among Ukrainian refugees in Switzerland
AU - T Krasnova
AU - K Schuerch
AU - A Frahsa
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.2054
UR - https://doi.org/10.1093/eurpub/ckag169.2054
AB - Background: Smoking remains a major public health concern in Switzerland where 22.2% smoking prevalence among women (23.5% men) substantially exceeds that in Ukraine with 9.8% (35.1% for men, all 2025). Since 2022, Ukrainians represent a large and distinct refugee group, predominantly women, potentially vulnerable to acculturation-driven tobacco use increases. Switzerland’s weak tobacco control environment heightens this risk. This study examines behaviours, knowledge and attitudes towards tobacco and nicotine use among Ukrainian refugees using data from the PATHS survey. Methods: PATHS collected data from migrants in Switzerland between May 2025 and May 2026. We conducted a descriptive analysis of Ukrainian refugees (arrived 2022 or later; n = 248; aged 15–76, IQR 32–50; 72% female; 75% tertiary education), assessing smoking prevalence and attitudes towards tobacco control. Analyses of smoking knowledge and attitudes are ongoing. Results: Overall, 172 (69%, 66% of participating women) had ever used tobacco or nicotine products and 56 (23%, 18% of women) reported current use. Cigarettes were most common (77%; 14% of women), followed by e-cigarettes (38%; 7% of women) and heated tobacco products (25%; 6% of women). 15% (18% of women) reported no smoking among family or friends. 45% reported contact with tobacco marketing in Switzerland. Despite this, 94% (96% of women) supported a ban on smoking in public spaces. Conclusions: Despite socio-demographic profiles typically associated with lower smoking risk, tobacco use is common alongside high marketing and social exposure. The predominantly women and younger Ukrainian refugee population faces particular acculturation risk, entering a country where smoking is less gendered and product are advertised more extensively than in Ukraine. Strong support for public smoking bans signals readiness for stricter tobacco control, including advertising restrictions and taxation, to prevent additional burden on the Swiss health system. Key messages: • Swiss female smoking prevalence is 2.5x higher than in Ukraine — Ukrainian refugee women face significant acculturation-driven risk of increased tobacco use. • High marketing exposure and social smoking normalisation among Ukrainian refugees in Switzerland call for stronger advertising restrictions and taxation.
SN - 1101-1262
SN - 1464-360X
ER -