A gendered acculturation risk: Tobacco and nicotine use among Ukrainian refugees in Switzerland

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.