Abstract
Surveys on tobacco consumption represent an important decision aid for public health policy related to smoking. Although Switzerland's tobacco control policies and regulations are among the weakest, its reported smoking prevalence is among the lowest in Europe. However, there appears to be a discrepancy between reported prevalence and aggregate data on national cigarette consumption. Our purpose was to closely look at this discrepancy and study its significance. Calculation of national aggregate tobacco consumption by Switzerland's resident population for the years 2012 to 2015 and comparison with reported consumption derived from survey results on smoking prevalence and intensity. Comparison with similar data for France for year 2014. Evaluation of several hypotheses to explain the discrepancy between survey results and national aggregate consumption data. There was a large discrepancy of about 45% between reported smoking consumption implied by survey results and estimated actual consumption derived from aggregate data on sales. Whereas survey results suggest smoking prevalence in Switzerland to be around 25% and rather stable during the period 2012 to 2015, true prevalence could be greater than 31%. The results of surveys aiming to estimate smoking prevalence and intensity in Switzerland may substantially suffer from underreporting, misreporting and sampling bias. Survey methodology needs to be examined to see whether such reporting discrepancy can be reduced.
Highlights
Every year, more than 9000 persons die in Switzerland because of tobacco-related illnesses, which account for around 15% of all deaths in this country [1]
Whereas survey results suggest smoking prevalence in Switzerland to be around 25% and rather stable during the period 2012 to 2015, true prevalence could be greater than 31%
The Swiss Lung League [3] estimates that 400 000 persons suffer from chronic obstructive pulmonary disease (COPD) alone, a disease which is mostly caused by smoking (80 to 90% of persons with COPD are smokers).) According to official statistics, smoking prevalence in Switzerland is among the lowest in Europe; adult daily
Summary
More than 9000 persons die in Switzerland because of tobacco-related illnesses, which account for around 15% of all deaths in this country [1]. The present study was motivated by a crude comparison we had made between reported results of FOPH population-based surveys and aggregate measures of national tobacco consumption, which exhibited a substantial discrepancy, suggesting that official statistics might perhaps underestimate the actual prevalence of smoking in Switzerland. Could it be that legislators and other public health professional base their tobacco control policy decisions on smoking prevalence estimates that are more reassuring than may be justified? This is seen notably when total consumption estimated through survey data (hereafter called reported consumption, following Kenneth Warner’s terminology [14]) is compared with consumption figures estimated from national aggregate data
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