ArticleJMIR pediatrics and parenting2026
Exposure to e-Cigarette Posts Across Social Media Platforms and Its Associations With Susceptibility and e-Cigarette Use: Comparative Cross-Sectional Study of High Schoolers in Jalisco (Mexico) and Southern California (United States).
Article in JMIR pediatrics and parenting, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdolescents' exposure to electronic cigarette (e-cigarette) content through social media platforms influences their perceptions and behaviors, although cross-country analyses in different regulatory environments are scarce.
objectiveThis study evaluated the association between e-cigarette exposure on social media platforms and e-cigarette susceptibility and use in Jalisco (Mexico) and Southern California (United States).
methodsIn 2022-2023, students from 23 high schools in Jalisco (n=1418) and 11 in Southern California (n=2953) were surveyed with harmonized measures on past-month frequency of social media platform use (ie, YouTube [Google], Instagram [Meta], TikTok [ByteDance], Snapchat [Snap Inc], WhatsApp [Meta], Facebook [Meta], Twitter (now "X"), and Twitch [Twitch Interactive]) and seeing e-cigarette posts on each social media platform used; which were recoded to 5-point scores (range 0-4) for social media platforms use and e-cigarette post exposure. Country-stratified logistic models regressed e-cigarette susceptibility (among noncurrent users) and past-month use on social media platform scores, adjusting for age, sex, family affluence, and friends' e-cigarette use.
resultsPast-month e-cigarette use was higher in Jalisco (248/1418, 17.5%) than Southern California (139/2953, 4.7%; P<.001). Social media use and e-cigarette exposure on each social media platform differed across samples (P values<.001). In Southern California, more frequent social media use was positively associated with e-cigarette susceptibility (adjusted odds ratio [AOR] 1.83, 95% CI 1.48-2.25), whereas in Jalisco, higher frequency of exposure to e-cigarette content was associated with susceptibility (AOR 1.21, 95% CI 1.02-1.43). Higher frequency of social media use and exposure to e-cigarette content were both positively associated with past-month e-cigarette use in Southern California; in Jalisco, greater exposure to social media platforms and e-cigarette content was associated with past-month use.
conclusionsFrequent social media platform use and e-cigarette exposure through social media platforms appear to be associated with e-cigarette susceptibility and use across contexts. Stronger policies to limit and enforce online exposures are needed.
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