Previous research has suggested that young adults are commonly exposed to e-cigarette-related marketing or user-generated content on social media. A new study was conducted to examine whether a) social media e-cigarette exposure is associated with e-cigarette use outcome expectancies and current e-cigarette use; and b) the association between social media and e-cigarette use is linked via outcome expectancies. Participants (N = 470) included Hawaii college students, between the ages of 18 to 25. Participants completed an online survey, in which they reported their demographic characteristics and the following. Social media e-cigarette exposure was measured by asking questions about frequency of use of certain social media as well as how often they saw e-cigarette related posts on each social media. Outcome expectancies (social enhancement, positive “smoking” experience, affect regulation experience and positive sensory experience) were measured by asking participants how likely or unlikely it would be for them to experience an outcome if they were to use an e-cigarette. E-cigarette use in one’s social network was measure by asking participants to nominate up to five persons who they are close with and questions about his or her e-cigarette use behavior. Cigarette use among participants was measured by asking participants about their smoking history, with questions such as “How many cigarettes have you smoked in your entire life?” Lastly, e-cigarette use was measured with questions about lifetime e-cigarette use and frequency of e-cigarette use. The authors used descriptive statistics computed in SAS as well as structural equation modeling (SEM) in Mplus for data analysis. Results showed that 44% of participants had never smoked a cigarette and 43% of participants had never used an e-cigarette. Furthermore, 18% of participants were current cigarette smokers and 25% were current e-cigarette smokers. In addition, participants were more likely to have seen e-cigarette-related ads or other posts “sometimes” or “often” on Facebook, followed by Instagram and Twitter. Moreover, 19% and 16% of the participants reported having seen e-cigarette ads “sometimes” or “often” on Facebook and Instagram, respectively. Similarly, 24% and 20% of participants reported having seen e-cigarette related posts on Facebook and Instagram “sometimes” or “often”, respectively. While higher social media e-cigarette exposure was significantly associated with higher positive outcome expectancies, only positive “smoking” experience and positive sensory experience were significantly associated with current e-cigarette use (p < 0.001). Social media e-cigarette exposure had a statistically significant total indirect effect on current e-cigarette use (p=0.008), mediated through positive “smoking” experience (p = 0.05) and positive sensory experience (p = 0.03) expectancies. Greater prevalence of e-cigarette use in individuals’ in-person social networks was significantly associated with higher positive outcome expectancies and was also directly associated with current e-cigarette use (p < 0.001). Being a current cigarette smoker or an experimenter was also directly associated with current e-cigarette use (p < 0.001).
Take away: This study found that social media e-cigarette exposure was associated with current e-cigarette use indirectly through two of the four positive outcome expectancies examined, specifically, positive “smoking” experience and positive sensory experience.