Social media use and child cigarette smoking and e-cigarette use: A cohort study 2015-2023

There are growing concerns that advertising and promotion on social media are driving youth use of tobacco and e-cigarettes. The UK provides an instructive example as it has high levels of e-cigarette use, high levels of social media use and a restrictive tobacco control environment. Existing evidence in the UK, however, has not focused on children, and has not been updated to reflect changes in patterns of social media use and in the use of these products. The aim of this study is to assess the associations of social media use with smoking and vaping.

Using data from the United Kingdom Household Longitudinal Study on adolescents aged 10-17 years between 2015-2023, we employed generalized estimating equation (GEE) models to estimate the relationships between time spent on social media and likelihood of smoking tobacco and using e-cigarettes. Models were controlled for possible confounders including sociodemographics and whether children lived in a home with e-cigarette use or tobacco smoking. We included data from 9359 participants with 25704 observations.

Current cigarette smoking was reported by 4.9% of the sample and current e-cigarette use by 3.1%. Our adjusted models found strong relationships between time spent on social media and both smoking and vaping (p for trend <0.001). For example, use of social media for ≥7 hours/day was linked to greater odds of tobacco (adjusted odds ratio, AOR=5.13; 95% CI: 3.32-7.95) and e-cigarette use (AOR=4.26; CI: 2.25-8.08).

This study finds associations between time spent on social media and both smoking and vaping among children. Enforcing regulations on content and restricting the duration of social media use may be warranted to protect children's health.