Social media’s influence on e-cigarette use onset and escalation among young adults: What beliefs mediate the effects?

• Published in: Addictive behaviors 2021-01, Vol.112, p.106617-106617, Article 106617
• Main Authors: Pokhrel, Pallav, Ing, Claire, Kawamoto, Crissy T., Laestadius, Linnea, Buente, Wayne, Herzog, Thaddeus A.
• Format: Article
• Language: English
• Subjects: Adult; Cross-Sectional Studies; E-cigarettes; Electronic Nicotine Delivery Systems; Female; Humans; Male; Outcome expectancies; Prospective Studies; Social Media; Vaping; Young Adult; Young adults
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2020.106617

•Social media influences e-cigarette use initiation and escalation.•Social media influences e-cigarette use onset through affect regulation beliefs.•Social media influences e-cigarette use escalation via positive ‘smoking’ beliefs.•Social media influences e-cigarette use escalation via positive sensory beliefs. As an extension of a previous cross-sectional study, this study employed prospective data to test positive outcome expectancy beliefs as mediators of social media’s influence on e-cigarette use progression among young adults. Self-report data were collected from 2327 young adult college students (Mean age = 21.2; SD = 2.1; 54% women) between 2017 and 2019, every 6-month, at 3 time-points. Structural equation modeling was used to test the mediational models. Among baseline never e-cigarette users, higher affect regulation expectancies—e.g., beliefs that e-cigarette use results in feeling good, reduced boredom and stress—mediated the effects of higher baseline social media e-cigarette exposure on e-cigarette use onset one year later. Among baseline lifetime e-cigarette users, higher positive sensory, positive “smoking” experience, and affect regulation expectancy beliefs mediated the effects of higher social media e-cigarette exposure at baseline on increased current e-cigarette use one year later. E-cigarette content on social media may persuade young adults to try e-cigarettes by imparting the sense that e-cigarettes make one feel good and help reduce stress. E-cigarette content on social media that promote e-cigarette flavors and e-cigarettes as cleaner and a socially more acceptable alternative to cigarettes may work to escalate e-cigarette use among experimenters. Efforts to prevent e-cigarette use onset and escalation may need to target the outcome expectancy beliefs influenced by social media.