Influence of Social Media on E-Cigarette Use: Stricter Regulations and Education Needed

The University of Macau found that social media health communication significantly influences e-cigarette perceptions and use, with notable shifts during the COVID-19 pandemic. Stricter regulations and targeted harm education are recommended to counteract misleading e-cigarette promotions and reduce usage.

A study by researchers from the Department of Communication and the Institute of Collaborative Innovation at the University of Macau explored the influence of health communication on social media regarding e-cigarette perception and use from 2017 to 2020, discovering significant trends and shifts in public attitudes and behaviors. E-cigarettes have rapidly gained prevalence, particularly in the United States, where the number of frequent users increased by 2.2 million between 2017 and 2020. This rise coincides with the rapid development of digital technologies and the increasing use of social media as a platform for health communication.

Social media, including platforms like Facebook, Twitter, and YouTube, has become a crucial channel for disseminating health-related information, shaping public perceptions and behaviors concerning e-cigarettes. The study analyzed four years of data from the U.S. Health Information National Trends Survey (HINTS), involving 9,914 participants aged 18-64. The researchers aimed to understand how social media health communication influences e-cigarette perceptions and use, guided by the Health Belief Model (HBM). The findings revealed a dynamic interaction between communication, perception, and behavior. Over the four-year period, social media health communication and perceived relative harm of e-cigarettes both increased. Interestingly, higher social media health communication was directly associated with more e-cigarette use in 2019 but indirectly linked to reduced use through increased harm perception in 2020.

Smokers More Sensitive to Harm Perception: A Closer Look

The study highlighted that smokers are more sensitive to harm perception compared to non-smokers. Smokers showed heightened responsiveness to harm messages, resulting in a more significant reduction in e-cigarette use when perceiving higher harm. This sensitivity underscores the potential effectiveness of targeted harm education for smokers. The researchers observed two mechanisms through which social media health communication influences e-cigarette use: directly and indirectly. Directly, social media can lead to increased e-cigarette use, especially when positive claims about e-cigarettes dominate the narrative. Indirectly, social media can reduce e-cigarette use by increasing the perceived harm of e-cigarettes, as more accurate health information becomes available. The study found that the pathways through which social media health communication affected e-cigarette use changed over time, influenced by public health events such as the COVID-19 pandemic and the e-cigarette, or vaping, product use-associated lung injury (EVALI) outbreak.

COVID-19 Pandemic Shifts Public Sentiment Towards E-Cigarettes

In 2020, there was a notable shift in public sentiment towards e-cigarettes, with increased awareness and perceived harm leading to reduced use. This shift was attributed to the heightened health discussions on social media during the COVID-19 pandemic, which made individuals more cautious about e-cigarette use. The study also noted a decline in e-cigarette sales in the U.S. in 2020, aligning with the observed decrease in use. The findings have significant implications for public health communication strategies. The study suggests the need for stricter regulations on unverified e-cigarette advertisements on social media and the promotion of anti-e-cigarette education campaigns. Such measures could help curtail e-cigarette use by providing accurate information and countering misleading claims by e-cigarette manufacturers. The researchers emphasized the importance of health policymakers closely monitoring social media's role in shaping public perceptions and behaviors towards e-cigarettes, adapting policies to address the evolving digital health communication landscape.

Social Media as a Mirror of Health Perceptions

The researchers observed that social media health communication trends and their impact on e-cigarette use were influenced by the dynamic nature of the digital environment and significant public health events. For instance, during the COVID-19 pandemic, social media became a vital platform for the public to access and exchange health-related information, leading to a shift in e-cigarette perceptions. The study also highlighted the role of social media in mirroring changes in the social environment, with the public's uncertainty in harm perception decreasing each year as more health evidence appeared. The researchers noted that while pro-e-cigarette content still surpasses anti-e-cigarette content, sentiment has shifted negatively since 2019, particularly on platforms like Twitter during the COVID-19 pandemic.

Implications for Public Health and Policy

In addition to examining the influence of social media health communication on e-cigarette use, the study also investigated the moderating effects of smoking status. The findings revealed that smokers exhibited heightened sensitivity to e-cigarette harm perception, leading to more substantial reductions in usage when perceiving e-cigarettes as more dangerous. This implies that targeted harm education for smokers may be particularly effective. The study's theoretical contributions lie in revealing the mechanisms underlying the association between social media health communication and e-cigarette use, both directly and indirectly. The practical implications include the need for tailored anti-tobacco campaigns and interventions on social media to guide people to perceive the harm of e-cigarettes more accurately and stricter regulation of e-cigarette advertisements on social media. The researchers also emphasized the importance of clinical professionals implementing e-health education to help individuals discern accurate information on social media.

The study underscores the powerful impact of social media health communication on e-cigarette perceptions and use, revealing the dynamic nature of public attitudes influenced by social media, particularly during significant public health events. The findings highlight the necessity for robust health communication strategies and regulatory measures to ensure that social media serves as a reliable source of health information, ultimately promoting better public health outcomes. Understanding the effects of social media and the impact of the dynamic environment is crucial for public health policymakers. Implementing stricter regulations for unverified e-cigarette advertisements and anti-e-cigarette education on social media is recommended to curb e-cigarette use.