Patterns of ENDS-Related Content Exposure on Social Media Among US Adolescents and Young Adults

Many US adolescents and young adults (AYA) are exposed to electronic nicotine delivery systems (ENDS)-related content regularly through social media platforms. Prior research treats exposure to ENDS-related content as uniform, both in its source and theme.

This study examined the variation in frequency, source, and theme of ENDS-related content online among AYA (ages 12-25), using the nationally representative Population Assessment of Tobacco and Health (PATH) Study Wave 7 (2022/23) data. Latent class analysis was used to identify patterns of ENDS-related content exposure among AYA who reported viewing ENDS-related content on social media in the past week (N = 4031). Multinomial logistic regression was used to examine associations of sociodemographic characteristics and tobacco/nicotine use behaviors with class membership.

Seven classes of ENDS-related content exposure were identified: (1) Memes from Friends (11.5%); (2) News & Information from Health Campaigns (7.6%); (3) Public Health Campaigns Only (23.2%); (4) Public Health Information & Memes (27.5%); (5) Celebrity/Influencer Posts (15.6%); (6) Mixed-Theme Brand Posts (3.5%); and (7) Multidimensional Frequent Exposure (11.1%). Young (ages 12-17), female, and racial/ethnic minority participants were more likely to be exposed to classes characterized by multiple types of content at higher frequencies. Past-year ENDS use was only associated with class membership in Memes from Friends relative to Public Health Campaigns Only.

AYA exposure to ENDS-related social media content is not uniform and may not be driven by tobacco/nicotine use. Sociodemographic groups previously targeted by combustible tobacco/nicotine marketing are more likely to be exposed to myriad ENDS-related content online.

ENDS-related content on social media is not uniform, and exposure varies considerably by source, theme, and frequency. Some exposure patterns were driven by public health information, while others were centered on entertainment and promotional content. Regulation of ENDS-related content online should be bolstered and enforced by federal institutions and social media platforms to curb promotional content for those not legally allowed to purchase or use ENDS. Additionally, future research should examine whether certain ENDS-related content exposure is associated with the tobacco/nicotine use initiation and escalation, particularly among sociodemographic groups that may be targeted to receive this content.