An Analysis of Social Media and Electronic Cigarette Use by Middle and High School Students Surveyed by the National Youth Tobacco Survey in 2023.

INTRODUCTION/OBJECTIVES: This study analyzed the relationship between social media use, perceptions of harm, demographic factors, and the likelihood of electronic cigarette use in middle and high school students in the United States, using data from the 2023 National Youth Tobacco Survey (NYTS).

METHODS

A total of 22 069 students participated in the 2023 NYTS, with 16 845 included in the final analysis after excluding those with missing data. The survey collected self-reported data on e-cigarette use, social media engagement, perceptions of harm and addictiveness, and environmental exposure to e-cigarettes. Adjusted odds ratios (OR) were calculated to assess the association between these factors and e-cigarette use.

RESULTS

Two thousand four hundred ninety-eight students (14.8%) reported ever using e-cigarettes, with older students showing significantly higher odds of e-cigarette use than younger students. Non-Hispanic Black and other racial groups had lower odds of e-cigarette use compared to non-Hispanic White students. Adolescents who perceived e-cigarettes as more harmful or more addictive than cigarettes were less likely to have used them. Social media behaviors were also strongly associated with e-cigarette use, with students who used social media less frequently having lower rates of e-cigarette use. Other social media related findings showed that students who frequently saw, posted, or interacted with e-cigarette-related content were significantly more likely to try e-cigarettes. Exposure to e-cigarette use at home and in vehicles further increased the likelihood of use.

CONCLUSION

This study highlights the influence of social media exposure, perceptions of harm, and demographic factors on adolescent e-cigarette use. Older students and those with greater exposure to e-cigarette-related content on social media are at higher risk for e-cigarette experimentation. Public health efforts should focus on addressing social media influences, correcting misperceptions about peer use, and educating adolescents on the risks of e-cigarette use to mitigate this growing public health concern.