Abstract: Youth Social Media Use Patterns as Predictors of Vaping Experimentation and Pro-Vaping Beliefs

◆ Chioma Woko, University of Pennsylvania
◆ Robert Hornik, University of Pennsylvania

Introduction: From the persistent marketing of popular electronic cigarette brands, to videos of vaping tricks, there is a wealth of pro e-cig content on social media sites (Huang et al., 2019). These portrayals and promotions of electronic cigarette use in the media environment are contributing to a perception of descriptive norms, both at the population level, and within peer networks (Cho et al., 2019; Liu et al., 2019). This calls for concern among public health researchers due to the predominance of adolescents and young adults on popular social media platforms, and the proven relationship between routine exposure to health-related media content and future behavior (Hornik et al., 2013). Thus, separately examining combustible cigarette smokers and non-smokers, we sought to investigate the relationship between frequency and type of social media use, and the likelihood of vaping among adolescents. Additionally, we were interested in seeing whether pro-vaping beliefs mediated this relationship, and to what extent. Understanding these relationships can inform strategies for the development and deployment of media-based anti-vaping campaigns.

Method: A weekly rolling cross-sectional survey was administered to a nationally representative sample between 2014-2017 in order to understand their tobacco and e-cigarette-related behaviors and beliefs, as well as their media engagement patterns. Participants were 13 to 25-year-olds who were contacted by phone at two time points, N=11,847 at baseline, and N=4470 six months later at recontact. A variety of regression models were used to determine the associations between social media patterns at baseline and vaping behavior at recontact, cross-sectional baseline associations between pro-vaping beliefs and social media use, as well as pro-vaping beliefs at baseline and vaping behaviors at recontact. Age, race, and, for lagged models, prior vaping was controlled for in all models.

Results: Among non-smokers, greater baseline use of Facebook, Instagram, and Twitter was significantly associated with reporting ever vaping at recontact, adjusting for ever-vaping at baseline (OR = 1.06, p = .023; OR = 1.06, p = .022; OR = 1.05, p = .033). More frequent use of these three platforms was also significantly associated with believing that vaping was less harmful than smoking, and that e-cigs can be used as a smoking cessation tool. These baseline beliefs predicted vaping at recontact (OR = 2.09, p = .032). Tumblr and YouTube use were not significant predictors of vaping. There were no significant relationships between the media and belief or behavior variables for current smokers.

Conclusion: Non-smoking adolescents who are frequent users of popular social media sites are more likely to try vaping and have favorable vaping-related beliefs. Although our measures do not specifically assess participants’ exposure to pro-vaping messages, it is highly plausible that more engagement with these social media sites increases the likelihood of coming across such content due to their prevalence on the sites. Routine exposure to these messages may increase vaping intentions, and ultimately, behavior. Health communication campaigns aiming to prevent uptake of vaping among non-cigarette smoking adolescents should target users of these platforms, as well as addressing these particular beliefs within the campaign messages.