Objectives This study aimed to examine how migration background is associated with current smoking and whether this relationship varies by sex, age, and education. Methods We analysed data from 19,441 participants of the 2022 Swiss Health Survey, an official, national cross-sectional dataset. Current smoking (yes/no) was the outcome, and migration background (none, 1st generation, 2nd or higher generation) the primary exposure. Multivariable logistic regression models adjusted for sociodemographic and behavioural covariates, were followed by stratified analyses by sex, age, and education. Results Compared to people without a migration background, the odds of current smoking were elevated among those with a 1st-generation background (OR = 1.42, 95% CI: 1.28-1.49) and 2nd or higher generation (OR = 1.75, 95% CI: 1.48-2.06). Stratified analyses showed that the higher odds of current smoking among people with a migration background were particularly pronounced among younger adults (15-24, 25-34 years), and among people with lower educational attainment. Conclusion Migration background contributes to smoking inequalities in Switzerland and intersects with other social factors, such as age and education. Elevated risks among people with 2nd or higher-generation migration backgrounds in younger age groups and those with lower educational attainment demonstrate the need for culturally adapted, equity-oriented prevention strategies and stronger national tobacco control policies.
