Mechanisms of Social Media Effects on Attitudes Toward E-Cigarette Use: Motivations, Mediators, and Moderators in a National Survey of Adolescents

Abstract

Background Exposure to risk behavior on social media is associated with risk behavior tendencies among adolescents, but research on the mechanisms underlying the effects of social media exposure is sparse. Objective This study aimed to investigate the motivations of social media use and the mediating and moderating mechanisms of their effects on attitude toward electronic cigarette (e-cigarette) use among adolescents. Methods Using data from a national sample survey of adolescents (age=14-17 years, N=594), we developed and validated a social media use motivation scale. We examined the roles of motivations in the effect of social media use on risk exposure and risk attitude. Results Motivations for social media use included agency, self-expression, realism, social learning, social comparison, and filter. These motivations were associated differentially with the frequency of use of Facebook, Instagram, Snapchat, and YouTube. Frequency of social media use was positively associated with exposure to e-cigarette messages across the four platforms ( P s<.001). Exposure to e-cigarette messages on Instagram ( P =.005) and Snapchat ( P =.03) was positively associated with attitude toward e-cigarette use. Perceived social media realism moderated the effects of e-cigarette message exposure such that when realism was high, the exposure effect was amplified, but when realism was low, the effect was mitigated ( P <.001). A three-way interaction effect ( P =.02) among exposure, social learning motivation, and social norm on attitude toward e-cigarette use was found. When perceived social norm was high, the moderating effect of social learning motivation on e-cigarette use attitude was amplified, but when social norm was low, the social learning motivation effect was attenuated. Conclusions Because perceived social media realism moderates the effect of exposure to e-cigarette messages on attitude toward e-cigarette use, future intervention efforts should address the realism perceptions. The three-way interaction among exposure, social learning motivation, and social norm indicates the importance of addressing both the online and offline social environments of adolescents. The social media use motivation scale, reflecting perceived affordances, is broadly applicable. Understanding social media use motivations is important, as they indirectly influence attitude toward e-cigarette use via frequency of social media use and/or frequency of exposure to e-cigarette messages on social media.

Social Media Use, eHealth Literacy, Disease Knowledge, and Preventive Behaviors in the COVID-19 Pandemic: Cross-Sectional Study on Chinese Netizens

“…Time and frequency are often used to measure the regularity of social media use [ 51 ]. We attempted to draw an explanation from previous studies that investigated the relationship between social media use frequency and behavioral outcomes; we found that “frequency” may be a direct indicator of the motivations of social media use, such as self-expression, social learning, social comparison, or filtering [ 52 , 53 ]. Therefore, we cautiously concluded that frequency of social media use indicates the degree of engagement or investment in social media.…”

The Vaping Teenager: Understanding the Psychographics and Interests of Adolescent Vape Users to Inform Health Communication Campaigns

“…Hip Hop and Popular adolescents and current vape users also reported extensive smartphone and social media use, in particular the use of Instagram, Snapchat, sports analysis sites, and video/music streaming services. Heavy social media use may contribute to adolescent vaping as user- and industry-generated vaping content abounds across platforms, 70-74 and early research suggests that heavier social media use and exposure to vape advertisements on social media are associated with willingness and intentions to vape. 75 Given the known association between exposure to online tobacco marketing and adolescent tobacco initiation and progression, 76,77 heavy social media use among Hip Hop and Popular adolescents may further explain why these youth vape.…”

Tobacco prevention education for middle school and high school educators

“…A framework of multilevel influences, first created by Urie Bronfenbrenner (1977), later identified five distinct social sources of behavioural influence: intrapersonal, interpersonal, organisational/institutional, community, and policy (McLeroy et al, 1988). While most studies about e-cigarettes have examined the influence of intrapersonal factors such as peers’ attitudes towards e-cigarettes (Cho et al, 2019), interpersonal factors (e.g. family) (Fite et al, 2018), or public policy (Friedman et al, 2019), few studies have explored behavioural strategies at the organisational- or community-levels of the social ecological model.…”