Skip to main content
Top
Published in:

Open Access 01-12-2024 | Research

Age of tobacco, nicotine and cannabis use initiation in Switzerland: a sequence analysis among adolescents and young adults

Authors: Diana Fernandes, Lorraine Chok, Jérémy Cros, Luc Lebon, Karin Zurcher, Alexandre Dubuis, Cathy Berthouzoz, André Berchtold, Yara Barrense-Dias

Published in: BMC Public Health | Issue 1/2024

Login to get access

SUMMARY

Background

To explore at what age youth start using tobacco and/or nicotine products, which product is used first, product initiation sequences, and whether some socio-demographic characteristics are associated with substance use initiation.

Methods

Data were collected from an online questionnaire disseminated through social media and professional partners, targeting youth aged 14–25 in French-speaking Switzerland in August 2022. The final sample included 1362 participants. Respondents were asked whether they had already used cigarettes, e-cigarettes, hookah, snus, or cannabis at least once in their life (yes/no) and the age of the first time was asked for each substance when the answer was positive. Additionally, participants were asked about their substance use in the past 30 days. Respondents were classified according to age at onset of each tobacco/nicotine and cannabis product, and comparisons were made based on sociodemographic variables, including gender (cisgender female/cisgender male/transgender), perceived socioeconomic status (below average/average/above average), and age.

Results

Overall, in addition to those who reported no consumption, four distinct initiation profiles emerged from the classification. Cigarettes remain the most commonly used first product with an average age of 15.7 years. While cigarettes and hookah are present in all profiles, the order of first consumption varies from one profile to another, with cigarettes coming first in two profiles, hookah in one and e-cigarettes in the last. Furthermore, while the most common profile contains experimental consumption of the five products considered, some profiles do not contain cannabis, e-cigarettes and/or snus, for example. When divided by age groups, both 14-17-year-olds and 18-21-year-olds reported cigarette as their first product of initiation. Across the separate age groups (14–17, 18–21, 22–25), cigarettes consistently emerge as the primary used on average.

Conclusions

Cigarettes remain the first product to be used, but the younger the respondents, the earlier they start using e-cigarettes, and very close to cigarettes. Regarding current consumption patterns, e-cigarettes are becoming increasingly prominent.
Appendix
Available only for authorised users
Footnotes
1
The comma-separated numbers are explained by the application of weights.
 
Literature
1.
go back to reference Bovet P et al. Tobacco use, in Noncommunicable Diseases. 2023. pp. 134–140. Bovet P et al. Tobacco use, in Noncommunicable Diseases. 2023. pp. 134–140.
2.
go back to reference Richmond-Rakerd LS, Slutske WS, Wood PK. Age of initiation and substance use progression: a multivariate latent growth analysis. Psychol Addict Behav. 2017;31(6):664–75.CrossRefPubMedPubMedCentral Richmond-Rakerd LS, Slutske WS, Wood PK. Age of initiation and substance use progression: a multivariate latent growth analysis. Psychol Addict Behav. 2017;31(6):664–75.CrossRefPubMedPubMedCentral
3.
go back to reference Sharapova S, et al. Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014–2016. Tob Control. 2020;29(1):49–54.CrossRefPubMed Sharapova S, et al. Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014–2016. Tob Control. 2020;29(1):49–54.CrossRefPubMed
5.
go back to reference Reitsma MB, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and initiation among young people in 204 countries and territories, 1990–2019. Lancet Public Health. 2021;6(7):e472–81.CrossRefPubMedPubMedCentral Reitsma MB, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and initiation among young people in 204 countries and territories, 1990–2019. Lancet Public Health. 2021;6(7):e472–81.CrossRefPubMedPubMedCentral
6.
go back to reference Enquête « Santé et Lifestyle », 2022, OFSP. 2022. Enquête « Santé et Lifestyle », 2022, OFSP. 2022.
7.
go back to reference Ahern NR, Mechling B. E-cigarettes: a rising trend among youth. J PsychoSoc Nurs Ment Health Serv. 2014;52(6):27–31.CrossRefPubMed Ahern NR, Mechling B. E-cigarettes: a rising trend among youth. J PsychoSoc Nurs Ment Health Serv. 2014;52(6):27–31.CrossRefPubMed
8.
go back to reference Delgrande Jordan M, Balsiger N, Schmidhauser V. Consommation De substances psychoactives chez les 11 à 15 ans en Suisse – Situation en 2022 et évolution dans le temps. Addiction Suisse: Lausanne; 2023. Delgrande Jordan M, Balsiger N, Schmidhauser V. Consommation De substances psychoactives chez les 11 à 15 ans en Suisse – Situation en 2022 et évolution dans le temps. Addiction Suisse: Lausanne; 2023.
9.
go back to reference Gmel G, et al. Snus and Snuff Use in Switzerland among Young men: are there beneficial effects on Smoking? Nicotine Tob Res. 2018;20(11):1301–9.CrossRefPubMed Gmel G, et al. Snus and Snuff Use in Switzerland among Young men: are there beneficial effects on Smoking? Nicotine Tob Res. 2018;20(11):1301–9.CrossRefPubMed
11.
go back to reference Association suisse pour la prévention du tabagisme (AT). Puff Bar and other Disposable ENDS. 2022. Association suisse pour la prévention du tabagisme (AT). Puff Bar and other Disposable ENDS. 2022.
12.
go back to reference Chok L, et al. EnquêtL’usage’usage et les représentations des cigarettes électroniques jetables (puffs) parmi les jeunes romand·es, in RaDeons de santé 344. Unisanté – Centre universitaire de médecine générale et santé publique: Lausanne; 2023. Chok L, et al. EnquêtL’usage’usage et les représentations des cigarettes électroniques jetables (puffs) parmi les jeunes romand·es, in RaDeons de santé 344. Unisanté – Centre universitaire de médecine générale et santé publique: Lausanne; 2023.
13.
go back to reference Velarde Creze C, et al. New puff-like disposable electronic cigarettes: expert consensus on their regulation. Revue Medicale Suisse. 2023;19(812):181–5.PubMed Velarde Creze C, et al. New puff-like disposable electronic cigarettes: expert consensus on their regulation. Revue Medicale Suisse. 2023;19(812):181–5.PubMed
14.
go back to reference Ma C, et al. Prevalence and trends in tobacco use among adolescents aged 13–15 years in 143 countries, 1999–2018: findings from the Global Youth Tobacco Surveys. Lancet Child Adolesc Health. 2021;5(4):245–55.CrossRefPubMed Ma C, et al. Prevalence and trends in tobacco use among adolescents aged 13–15 years in 143 countries, 1999–2018: findings from the Global Youth Tobacco Surveys. Lancet Child Adolesc Health. 2021;5(4):245–55.CrossRefPubMed
15.
go back to reference Spilka S, et al. Les drogues à 17 ans: analyse régionale. Enquête ESCAPAD 2017. OFDT; 2018. Spilka S, et al. Les drogues à 17 ans: analyse régionale. Enquête ESCAPAD 2017. OFDT; 2018.
16.
go back to reference Morel d’Arleux J, et al. Les drogues à 17 ans. Analyse De l’enquête ESCAPAD 2022. Observatoire français des drogues et des tendances addictives: Paris; 2023. Morel d’Arleux J, et al. Les drogues à 17 ans. Analyse De l’enquête ESCAPAD 2022. Observatoire français des drogues et des tendances addictives: Paris; 2023.
17.
go back to reference Melchior M, et al. Early cannabis initiation and educational attainment: is the association causal? Data from the French TEMPO study. Int J Epidemiol. 2017;46(5):1641–50.CrossRefPubMed Melchior M, et al. Early cannabis initiation and educational attainment: is the association causal? Data from the French TEMPO study. Int J Epidemiol. 2017;46(5):1641–50.CrossRefPubMed
19.
go back to reference Sagar KA, et al. The impact of initiation: early onset marijuana smokers demonstrate altered Stroop performance and brain activation. Dev Cogn Neurosci. 2015;16:84–92.CrossRefPubMedPubMedCentral Sagar KA, et al. The impact of initiation: early onset marijuana smokers demonstrate altered Stroop performance and brain activation. Dev Cogn Neurosci. 2015;16:84–92.CrossRefPubMedPubMedCentral
20.
go back to reference Millar SR, et al. Relationships between age at first substance use and persistence of cannabis use and cannabis use disorder. BMC Public Health. 2021;21(1):997.CrossRefPubMedPubMedCentral Millar SR, et al. Relationships between age at first substance use and persistence of cannabis use and cannabis use disorder. BMC Public Health. 2021;21(1):997.CrossRefPubMedPubMedCentral
21.
22.
go back to reference Wang TW, et al. Tobacco product use among middle and high school students—United States, 2011–2017. Morb Mortal Wkly Rep. 2018;67(22):629.CrossRef Wang TW, et al. Tobacco product use among middle and high school students—United States, 2011–2017. Morb Mortal Wkly Rep. 2018;67(22):629.CrossRef
23.
go back to reference Quednow BB, et al. High prevalence and early onsets: legal and illegal substance use in an urban cohort of young adults in Switzerland. Eur Addict Res. 2022;28(3):186–98.CrossRefPubMed Quednow BB, et al. High prevalence and early onsets: legal and illegal substance use in an urban cohort of young adults in Switzerland. Eur Addict Res. 2022;28(3):186–98.CrossRefPubMed
24.
go back to reference Ansteinsson V, et al. Factors associated with initiation and use of snus among adolescents. Scand J Public Health. 2023;51(1):44–52.CrossRefPubMed Ansteinsson V, et al. Factors associated with initiation and use of snus among adolescents. Scand J Public Health. 2023;51(1):44–52.CrossRefPubMed
25.
go back to reference Ali SH, et al. Social media as a recruitment platform for a nationwide online survey of COVID-19 knowledge, beliefs, and practices in the United States: methodology and feasibility analysis. BMC Med Res Methodol. 2020;20(1):116.CrossRefPubMedPubMedCentral Ali SH, et al. Social media as a recruitment platform for a nationwide online survey of COVID-19 knowledge, beliefs, and practices in the United States: methodology and feasibility analysis. BMC Med Res Methodol. 2020;20(1):116.CrossRefPubMedPubMedCentral
26.
go back to reference Shaver LG, et al. Using Facebook Advertising to Recruit Representative Samples: Feasibility Assessment of a cross-sectional survey. J Med Internet Res. 2019;21(8):e14021.CrossRefPubMedPubMedCentral Shaver LG, et al. Using Facebook Advertising to Recruit Representative Samples: Feasibility Assessment of a cross-sectional survey. J Med Internet Res. 2019;21(8):e14021.CrossRefPubMedPubMedCentral
27.
go back to reference Whitaker C, Stevelink S, Fear N. The Use of Facebook in Recruiting Participants for Health Research Purposes: a systematic review. J Med Internet Res. 2017;19(8):e290.CrossRefPubMedPubMedCentral Whitaker C, Stevelink S, Fear N. The Use of Facebook in Recruiting Participants for Health Research Purposes: a systematic review. J Med Internet Res. 2017;19(8):e290.CrossRefPubMedPubMedCentral
28.
go back to reference Belanger RE, et al. Adding Tobacco to Cannabis–its frequency and likely implications. Volume 13. Nicotine & Tobacco Research; 2011. pp. 746–50. 8. Belanger RE, et al. Adding Tobacco to Cannabis–its frequency and likely implications. Volume 13. Nicotine & Tobacco Research; 2011. pp. 746–50. 8.
29.
go back to reference Belanger RE, et al. To what extent does adding Tobacco to Cannabis expose young users to Nicotine? Nicotine Tob Res. 2013;15(11):1832–8.CrossRefPubMed Belanger RE, et al. To what extent does adding Tobacco to Cannabis expose young users to Nicotine? Nicotine Tob Res. 2013;15(11):1832–8.CrossRefPubMed
30.
go back to reference Hibell B, et al. The 2007 ESPAD report. Subst use among Students in. 2009;35:1–408. Hibell B, et al. The 2007 ESPAD report. Subst use among Students in. 2009;35:1–408.
31.
go back to reference Patton GC, et al. Puberty and the onset of substance use and abuse. Pediatrics. 2004;114(3):e300–6.CrossRefPubMed Patton GC, et al. Puberty and the onset of substance use and abuse. Pediatrics. 2004;114(3):e300–6.CrossRefPubMed
32.
33.
go back to reference Xing S, et al. Proportion and trend in the age of cigarette smoking initiation among adolescent smoking experiencers aged 13–15 years in 148 countries/territories. Front Public Health. 2022;10:1054842.CrossRefPubMedPubMedCentral Xing S, et al. Proportion and trend in the age of cigarette smoking initiation among adolescent smoking experiencers aged 13–15 years in 148 countries/territories. Front Public Health. 2022;10:1054842.CrossRefPubMedPubMedCentral
34.
go back to reference Evans-Polce RJ, et al. Initiation patterns and trends of E-Cigarette and cigarette use among U.S. adolescents. J Adolesc Health. 2020;66(1):27–33.CrossRefPubMed Evans-Polce RJ, et al. Initiation patterns and trends of E-Cigarette and cigarette use among U.S. adolescents. J Adolesc Health. 2020;66(1):27–33.CrossRefPubMed
35.
go back to reference Kuendig H. Enforcement of regional bans on tobacco sales to minors in Switzerland–example of missed opportunity? Eur J Public Health. 2011;21(6):750–2.CrossRefPubMed Kuendig H. Enforcement of regional bans on tobacco sales to minors in Switzerland–example of missed opportunity? Eur J Public Health. 2011;21(6):750–2.CrossRefPubMed
36.
go back to reference Tashakkori NA, et al. Multiple Tobacco Product Use among Youth E-Cigarette users: National Youth Tobacco Survey, 2020. J Adolesc Health. 2023;73(4):769–75.CrossRefPubMed Tashakkori NA, et al. Multiple Tobacco Product Use among Youth E-Cigarette users: National Youth Tobacco Survey, 2020. J Adolesc Health. 2023;73(4):769–75.CrossRefPubMed
37.
go back to reference Chen X, Yu B, Wang Y. Initiation of electronic cigarette use by Age among Youth in the U.S. Am J Prev Med. 2017;53(3):396–9.CrossRefPubMed Chen X, Yu B, Wang Y. Initiation of electronic cigarette use by Age among Youth in the U.S. Am J Prev Med. 2017;53(3):396–9.CrossRefPubMed
38.
go back to reference Jakob J, et al. The price of nicotine dependence: a comparison of the cost of nicotine across products in Switzerland, Germany, USA, Sweden, France and the UK, in 2019. Tob Prev Cessat. 2022;8:42.PubMedPubMedCentral Jakob J, et al. The price of nicotine dependence: a comparison of the cost of nicotine across products in Switzerland, Germany, USA, Sweden, France and the UK, in 2019. Tob Prev Cessat. 2022;8:42.PubMedPubMedCentral
39.
go back to reference Tucker JS, et al. Cannabis and tobacco use and co-use: trajectories and correlates from early adolescence to emerging adulthood. Drug Alcohol Depend. 2019;204:107499.CrossRefPubMedPubMedCentral Tucker JS, et al. Cannabis and tobacco use and co-use: trajectories and correlates from early adolescence to emerging adulthood. Drug Alcohol Depend. 2019;204:107499.CrossRefPubMedPubMedCentral
40.
go back to reference Hawke LD, Wilkins L, Henderson J. Early cannabis initiation: substance use and mental health profiles of service-seeking youth. J Adolesc. 2020;83:112–21.CrossRefPubMed Hawke LD, Wilkins L, Henderson J. Early cannabis initiation: substance use and mental health profiles of service-seeking youth. J Adolesc. 2020;83:112–21.CrossRefPubMed
41.
go back to reference Vogel T, et al. Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15-month follow-up? A longitudinal study involving young Swiss men. Addiction. 2016;111(10):1867–78.CrossRefPubMedPubMedCentral Vogel T, et al. Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15-month follow-up? A longitudinal study involving young Swiss men. Addiction. 2016;111(10):1867–78.CrossRefPubMedPubMedCentral
42.
go back to reference Céline K, et al. JAMES - Jeunes, activités, médias - enquête Suisse. ZHAW Zürcher Hochschule für Angewandte Wissenschaften: Zurich; 2022. Céline K, et al. JAMES - Jeunes, activités, médias - enquête Suisse. ZHAW Zürcher Hochschule für Angewandte Wissenschaften: Zurich; 2022.
43.
go back to reference Lebon L et al. Why did Swiss citizens vote to ban tobacco advertising? Tob Control, 2023. Lebon L et al. Why did Swiss citizens vote to ban tobacco advertising? Tob Control, 2023.
Metadata
Title
Age of tobacco, nicotine and cannabis use initiation in Switzerland: a sequence analysis among adolescents and young adults
Authors
Diana Fernandes
Lorraine Chok
Jérémy Cros
Luc Lebon
Karin Zurcher
Alexandre Dubuis
Cathy Berthouzoz
André Berchtold
Yara Barrense-Dias
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-20731-2