How Does Health Communication on Social Media Influence E-cigarette Perception and Use? A Trend Analysis from 2017 to 2020

• Published in: Addictive behaviors 2024-02, Vol.149, p.107875-107875, Article 107875
• Main Authors: Zhang, Luxi, Harris Ao, Song, Francis Ye, Jizhou, Zhao, Xinshu
• Format: Article
• Language: English
• Subjects: e-cigarette use; Electronic Nicotine Delivery Systems; harm reduction; Health Communication; Humans; Perception; public opinion; Social Media; Tobacco Products; tobacco use
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2023.107875

•Social media communication has divergent impacts on e-cigarette use in different years.•A rising trend in health communication using social media was identified.•A negative shift in public attitudes towards e-cigarettes post-2019 was found. E-cigarettes have achieved a high prevalence rapidly. While social media is among the most influential platforms for health communication, its impact on attitudes and behaviors of e-cigarettes and its changes over time remain underexplored. This study aims to address the gap. Four years of data (2017-2020) were derived from the U.S. Health Information National Trends Survey (HINTS) (aged 18-64 years, n = 9,914). Initially, key variables were compared across years. Furthermore, guided by the health belief model, we employed a moderated mediation model to examine the influence of social media health communication on the public’s perceptions and behaviors related to e-cigarettes, distinguishing between smokers and non-smokers throughout the four-year period. The evidence shows a process of dynamic interaction between communication, perception, and behavior. (1) We observed an increasing trend of social media health communication (SMH) and perceived relative harm of e-cigarettes (PHE). (2) Higher SMH was associated with more e-cigarette use directly in 2019. (3) Higher SMH was associated with less e-cigarette use indirectly through PHE in 2020. (4) Smokers consistently displayed heightened sensitivity in responding to harm perception compared to non-smokers. The findings support two mechanisms underlying the association between SMH and e-cigarette use: direct and indirect. The changes in the pathways during the timespan may have been influenced by increased e-cigarette information on social media and public health events like COVID-19. Stricter regulations for unverified e-cigarette advertisements and anti-e-cigarette education on social media are called for to curtail e-cigarette use.