Social Media Engagement, Youth E-Cigarette Use, and the Moderating Potential of Harm Perceptions.

Introduction: Adolescent electronic cigarette use is a significant public health concern due to its potential for negative health effects and prevalence among youth. The primary aim of the current study is to examine the moderation effect of perceived harm (i.e., low versus high) on the relation between passive and active social media use and past 30-day adolescent e-cigarette use. We hypothesized that the relation between type of social media use and e-cigarette use would be contingent on the level of perceived harm. Aims and Method: This study was conducted via secondary data analysis with the public use files from the 2023 National Youth Tobacco Survey that provides a nationally representative sample (N = 22,069) of youth in the United States. The primary analysis consisted of logistic regression that accounted for complex survey sampling and missing data; primarily testing for a moderation effect. Results: We found a significant omnibus interaction, F(2,37) = 3.83, Conclusions: We found that high versus low perceived harm moderated the relationship between passive and active engagement with e-cigarette-related social media content and past 30-day e-cigarette use for a nationally representative sample of adolescents in the U.S. Based on these findings, prevention strategies targeting adolescent e-cigarette use may be enhanced through tailoring educational messaging that focus on the potential effects of exposure to e-cigarette related social media content in conjunction with the known effects of using e-cigarettes on one's health. Implications: Examining the moderating effects of variables provides a greater understanding of the ways multiple factors interplay and influence adolescent e-cigarette use. The results of the current study demonstrated that differences between perceived levels of harm occurred at each category of social media use, while these differences were most pronounced between the passive use and the high active use social media categories. Prevention strategies targeting adolescent e-cigarette use may be enhanced through tailoring educational messaging and teaching strategies that focus on the potential effects of exposure to e-cigarette related social media content in conjunction with the known biological effects of using e-cigarettes on one's health.