Effect of Tobacco and E-Cigarette-Related Social Media Content on Youth

Introduction

E-cigarette and tobacco-related content on social media has been linked to various mechanisms of increased e-cigarette and tobacco use. This study aimed to synthesis the association between exposure to e-cigarette and tobacco-related content and youth behaviors and attitudes.

Methods

A comprehensive search was conducted as part of a larger study on social media and recreational substance use. Studies published post-2004 reporting effect estimates for exposure or engagement with e-cigarette or tobacco content on social media and behavior or attitude outcomes were included.

Results

32 studies (N = 274,283, 9-25 years) were included. Meta-analyses revealed significant associations between engagement with tobacco content and use, to content and never users’ risk and exposure to e-cigarette content and use. There was no observed relationship between exposure to tobacco content and ever users’ risk perceptions. Qualitative synthesis found significant associations between tobacco exposure and increased current use and pro-tobacco attitudes; e-cigarette exposure and increased susceptibility and reduced risk perceptions; tobacco engagement and increased susceptibility; e-cigarette engagement and increased use; dual exposure and increased susceptibility; and dual engagement and increased dual use. Mixed findings were identified for the influence of e-cigarette exposure on attitudes, tobacco exposure on susceptibility, dual exposure on dual use behaviors, and dual engagement on dual susceptibility.

Conclusion

Exposure to and engagement with content depicting e-cigarette or tobacco products may significantly influence the behaviors and attitudes of youth. Policies should continue to monitor the potential implications of interactions with this content and implementing strategies to reduce the impact of this content.