Meme Exposure on Social Media Associated with More Positive E-Cigarette Perceptions and Greater Usage Among Youth.

Internet memes, viral and mutable messages online, have been used by individuals and organizations to disseminate health messages. Specifically, both companies and public health organizations have used memes to influence e-cigarette behaviors. How does exposure to e-cigarette memes on social media shape related perceptions and behaviors among youth? This study extracted data from restricted-use file of Wave 7 (2022-2023) of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study that collected information about tobacco use and associated health behaviors among adults (≥18 years) and youth (12-17 years) in the United States. Our analyses investigated the association between youth participants' exposure to various sources of memes related to e-cigarette use and their e-cigarette-related expectancies, perceptions, use, and cessation, while controlling for parental and youth factors. Exposure to memes posted by friends and celebrities were all associated with lower perceived harmfulness, higher descriptive norms, more positive injunctive norms of using e-cigarettes, and more ease for purchasing e-cigarettes (ps<.05). For youth who do not use e-cigarettes, exposure to e-cigarette memes was associated with higher susceptibility of using e-cigarettes (ps<.01). Additionally, exposure to memes posted by friends was also associated with lower e-cigarette quit intentions. E-cigarette memes may influence youth's perceptions about e-cigarettes and contribute to initiation among youth. Future research is needed for identifying strategies in using Internet memes for e-cigarette prevention and health campaigns.