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Longitudinal associations of tobacco-related social media involvement with cigarette and e-cigarette initiation among US adolescents

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Abstract

Tobacco is the leading cause of preventable morbidity and mortality in the USA. Evidence suggests adolescents are particularly vulnerable to online tobacco marketing. This study examined longitudinal associations of following or liking of tobacco brands with subsequent cigarette and e-cigarette initiation among US adolescents. We used Wave 1–Wave 4 Population Assessment of Tobacco and Health study data (n = 6997) and discrete-time survival regression models to examine associations of past-year tobacco-related social media interactions with the initiation of cigarettes and e-cigarettes among US adolescents. About 4.8% (n = 280) of adolescent never cigarette users and 4.9% (n = 288) of never e-cigarette users followed or liked tobacco brands on social media between Wave 1 and Wave 2. By Wave 4, 8.8% of all cigarettes never users had initiated cigarette use, and 18.7% of never e-cigarette users initiated e-cigarette use. The following or liking tobacco brands on social media was significantly associated with increased odds of cigarette initiation (adjusted odds ratio (aOR) 2.12, 95% CI 1.56–2.88) and e-cigarette initiation (aOR 2.11, 95% CI 1.66–2.69). Also, the initiation of cigarettes and e-cigarettes differed significantly among race/ethnicity, school performance, and other tobacco and substance use.

Conclusion: Adolescents who followed or liked tobacco products on social media were more likely to initiate cigarette or e-cigarette use subsequently. Increasing anti-tobacco efforts on social media sites could be beneficial.

What is Known:

• Evidence suggests adolescents are particularly vulnerable to online tobacco marketing.

What is New:

• The following or liking tobacco brands on social media was significantly associated with the odds of cigarette and e-cigarette initiation.

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Data availability

Publicly available source, available at https://doi.org/10.3886/ICPSR36231.

Notes

  1. In discrete-time logistic regression models, the hazard is defined as the “conditional probability that a randomly selected individual will experience the target event (in this patient cigarettes/e-cigarettes initiation) in a period j, given that he or she did not experience the event before j [22].

Abbreviations

aOR:

Adjusted odds ratio

CI:

Confidence interval

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Authors and Affiliations

  1. Department of Family and Preventive Medicine, Division of Public Health, University of Utah School of Medicine, 375 Chipeta Way, Salt Lake City, UT, 84108, USA

    Lingpeng Shan & Sunday Azagba

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  1. Lingpeng Shan
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  2. Sunday Azagba
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Contributions

L.S, conceptualization, data analysis, writing, and result interpretation; S.A, writing, result interpretation, and review.

Corresponding author

Correspondence to Sunday Azagba.

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The authors declare that they have no conflict of interest.

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Communicated by Gregorio Paolo Milani

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Shan, L., Azagba, S. Longitudinal associations of tobacco-related social media involvement with cigarette and e-cigarette initiation among US adolescents. Eur J Pediatr 181, 189–196 (2022). https://doi.org/10.1007/s00431-021-04166-0

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  • DOI: https://doi.org/10.1007/s00431-021-04166-0

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