Abstract
BACKGROUND: Smoking rates in Switzerland remain disproportionately high among people with a migration background and with a low socioeconomic status. These groups face multiple access barriers and are often labeled as "hard-to-reach", underserved communities or disadvantaged in public health literature. Cessation strategies that are inclusive and setting-sensitive remain scarce and under-evaluated for these vulnerable populations. OBJECTIVES & DESIGN: The one arm pre-post non-clinical trial study aimed to implement and analyze a setting- and milieu-sensitive as well as a linguistically adapted community-based smoking cessation group intervention for disadvantaged groups with a migration background in Switzerland, and to assess its reach, acceptability, and behavioral effects. METHODS: A two-part workshop program, each lasting two hours, was delivered between 2022 and 2024 to 82 preexisting community groups in their native language across Switzerland. The intervention was conducted in 12 languages and embedded in daily life settings such as clubs and associations. Data was collected in six selected languages from 42 groups through telephone surveys at baseline (T1) and follow-up (T2, three months later). Key indicators included smoking status, quit attempts, reduction in daily cigarette consumption, and the activation of smoke-free social norms. Descriptive statistics were computed, and chi-square tests and paired-samples t-tests were used to analyze changes between baseline (T1) and follow-up (T2). RESULTS: Out of 795 participants from the 42 groups included in the analysis, N=184 completed the baseline survey, and 99 could be followed up at T2. Among smokers, 23% had quit cigarette smoking by follow-up, and 50% of those still smoking had made at least one quit attempt. Cigarette consumption decreased significantly. Over a quarter of non-smoking participants reported actively encouraging smokers in their environment to quit or reduce smoking, indicating normative diffusion through strong social ties. CONCLUSIONS: The findings suggest the potential of short, community-embedded interventions may hold considerable potential. When tailored to the specific social target groups and delivered in everyday environments, such programs may achieve relevant individual outcomes and promote broader shifts toward smoke-free norms within disadvantaged communities.