Social media exposure to tobacco content associated with increased tobacco use

According to a recent meta-analysis, people exposed to tobacco content on social media were more likely to report having used tobacco than those who were not. Investigators have called for regulation of social media marketing in the tobacco industry.

According to the findings of a study recently published in JAMA Pediatrics.

People who were exposed to tobacco content on social media were more than twice as likely to report tobacco use as people who were not exposed to tobacco content.

Researchers from the Keck School of Medicine at the University of Southern California conducted what is believed to be the first systematic review and meta-analysis to estimate the overall association between exposure to tobacco content on social networks. social status and lifetime tobacco use, past 30-day use and susceptibility to tobacco use in people who had never used tobacco.

“We cast a wide net through the tobacco and social media literature and synthesized it all into a single association summarizing the relationship between social media exposure and tobacco use,” said lead author Scott. Donaldson, PhD, senior research associate in the department at the Keck School of Medicine. population science and public health, said in a statement. “What we found is that these associations are strong and have public health implications at the population level.”

Data for the analysis comes from online databases, including MEDLINE, ISI Web of Science, Scopus and PsychINFO, using search terms on tobacco, social media and marketing. The content included user-generated “organic” posts and promotional material from various social media platforms, including Instagram, Facebook, Snapchat, YouTube, Twitter, Pinterest and Tumblr.

Included studies reported odds ratios (ORs) for self-reported or experimentally manipulated exposure to tobacco content on social media and lifetime tobacco use, past 30-day tobacco use, and susceptibility to smoking among never smokers. Tobacco use included e-cigarettes, cigarettes, cigars, hookahs, and smokeless tobacco.

A total of 29 peer-reviewed articles met the inclusion criteria for analysis, including the use of a control group. All studies were conducted after 2014, most from 2017 to 2021. Most studies, 79%, used digital surveys.

The total sample size was 139,625 participants from 24 included datasets. The majority of the sample, 72%, were teenagers. Young adults and adults made up 15% and 13% of the sample, respectively. Study locations included the United States, Australia, India, and Indonesia.

The analysis showed that participants who were exposed to tobacco content on social media were more than twice as likely to report lifetime tobacco use as those who were not exposed ( odds ratio [OR], 2.18; 95% CI, 1.54-3.08).

Participants who were exposed to this content also had a greater likelihood of reporting tobacco use in the past 30 days (OR, 2.19; 95% CI, 1.79-2.67) and sensitivity in use among never smokers (OR, 2.08; 95% CI, 1.65-2.63).

The researchers were particularly concerned about the increased sensitivity to use.

“The fact that people who had never used tobacco before were more susceptible is particularly significant,” said Jon-Patrick Allem, PhD, assistant research professor in the Department of Population and Public Health Sciences at the Keck School of Medicine, in the press release. “This suggests that exposure to tobacco-related content can spark interest and potentially drive non-users to switch to tobacco.”

Similar associations were found for active and passive engagement, meaning that simply watching tobacco content, as well as liking, commenting, or sharing, was associated with an increased likelihood of smoking and consumption sensitivity. Subgroup analyzes demonstrated that individuals who viewed content on 2 or more platforms also faced higher risks of tobacco use and consumption sensitivity compared to those on 1 platform alone.

These results demonstrate that exposure to tobacco content on social media can encourage tobacco use initiation and normalize tobacco use behaviors.

However, further research is needed to explore how different social platforms influence tobacco use and to assess causality between exposure to tobacco content on social media and tobacco use.

The authors suggest that the findings of this study warrant urgent attention to address youth exposure to tobacco-related discussions on social media through prevention education programs.

“First, we can work to design and implement interventions that counter the influence of pro-tobacco content, for example by educating teens about how the tobacco industry surreptitiously markets to them its products,” Allem said.

They recommend that public health practitioners consider these findings when designing interventions to counter the influence of pro-tobacco content on social media.

“The proliferation of social media has provided tobacco companies with new ways to promote their products, especially to teens and young adults,” Allem added. “Our hope is that policy makers and other stakeholders can use our study as a basis for decision-making and action.”

Given that tobacco industry marketing on social media is largely unregulated, the authors suggest that social media platforms ensure that there are adequate safeguards to reduce teens’ exposure to tobacco content. tobacco.

They plan to continue their research by analyzing tobacco prevention campaigns on social media to determine their effectiveness and the users they reach, digging deeper into specific platforms such as TikTok, and investigating how videos of various tobacco products can have an impact on sensitivity.


Donaldson SI, Dormenesh A, Perez C, Majmundar A, Allem JP. Association between exposure to tobacco content on social media and tobacco consumption: a systematic review and meta-analysis. JAMA Pediatrician. Published July 11, 2022. doi:10.1001/jamapediatrics.2022.2223