Effects of exposure to negative and positive social media content about vaping and nicotine addiction on beliefs and intentions to use e-cigarettes among young adults in the U.S.: results from a randomized controlled experiment.

INTRODUCTION

Noncommercial social media content presents vaping and nicotine addiction in both positive and negative terms. The effect of exposure to this content on young adults' attitudes, beliefs, and intentions to vape is unknown.

METHODS

We randomized 1816 U.S. young adults to view a series of real (i.e., not simulated), noncommercial, publicly accessible social media videos about nicotine addiction of the same valence (positive, negative, or control unrelated to nicotine addiction). Exposures included both YouTube and TikTok videos that had been uploaded to the YouTube platform. We explored associations between the social media exposure and intentions to use or quit e-cigarettes or cigarettes and related normative beliefs.

RESULTS

Controlling for tobacco use and sociodemographic characteristics, the positive valence group had 49% higher adjusted odds (aOR: 1.49, 95% CI: 1.08-2.04, p = 0.014) of reporting intentions to vape, but not smoke, compared with the control group. The negative valence group reported higher intentions to quit smoking, but not quit vaping, after adjustment (β = 1.36, 95% CI: 0.38-2.34, p = 0.007). Further, the negative valence group estimated a higher prevalence of peer vaping (β = 3.26, 95% CI: 0.33-6.19, p = 0.029) compared to the control group after adjustment. Injunctive normative beliefs were not significantly different between groups.

CONCLUSIONS

Brief exposure to videos that showed nicotine addiction in a favorable light was associated with greater vape intentions among young adults; content of different valences had differential impacts on subjective norms measures. Findings suggest the importance of actions to limit exposure to tobacco-related content on social media.