Social Media Engagement and Quit Intentions Among Youth With Exclusive E-cigarette Use: The Moderating Role of Social Norms.

Introduction: E-cigarette use is prevalent among US youth. Little is known about the association between engagement with e-cigarette-related social media posts, vaping norms, and intention to quit e-cigarettes among youth who exclusively use e-cigarettes.

Methods: A cross-sectional national online survey was conducted among a sample of youth aged 13-18 who reported exclusive e-cigarette use in the past 30 days. Logistic regression was used to estimate the association between engagement with e-cigarette-related posts on social media, vaping social norms, and intention to quit e-cigarettes. Two interaction terms were added between descriptive and injunctive norm variables and engagement with social media posts, respectively, to test the potential differential effect of social norms on intention to quit. Models were adjusted for demographic and e-cigarette use variables.

Results: The sample (N = 143) was 62% females; 69% identified as White and 20% as Black. Engaging with e-cigarette-related posts on social media was associated with higher odds of an intention to quit e-cigarettes compared to those who never engaged with e-cigarette posts [adjusted aOR = 2.70, 95%CI (1.13,6.42)]. Intention to quit e-cigarettes was lower among youth who believed the use of e-cigarettes was common (descriptive norms) [0.71, (0.57,0.88)], and who described the views of people important to them as positive (vs. negative; injunctive norms) [0.26, (0.07,0.98)]. Youth who engaged with posts and had positive views from people important to them on e-cigarettes (injunctive norms) were less likely to express an intent to quit vaping (aOR = 0.10; p-value = .0394).

Conclusions: Social media exposure and social norms may influence quit intentions among youth who exclusively use e-cigarettes. Targeted interventions on social media to address the potential of these factors in promoting cessation behaviors are needed.

Implications: Our study highlights the interplay between social media engagement, descriptive and injunctive social norms of vaping, and intention to quit e-cigarette use among youth who exclusively use e-cigarettes. These insights are crucial for designing effective, targeted social media-based cessation interventions, promoting quitting intentions, and addressing misperceptions about vaping, thereby supporting youth cessation behaviors.