Vaping, smartphones, and social media use among young adults: Snapchat is the platform of choice for young adult vapers

Exposure to user-generated e-cigarette content on social media associated with greater vulnerability to e-cigarette use among youth non-users

INTRODUCTION

Social media are important venues for youth's exposure to e-cigarette content. This study examined how exposure to user-generated e-cigarette content (i.e., content created and shared by individual social media users) is associated with vulnerabilities to e-cigarette use among youth non-users.

METHODS

We pooled data from the 2021 and 2022 National Youth Tobacco Survey. Youth who have never used e-cigarettes were included. Weighted linear and logistic regressions were conducted to examine how exposure to user-generated e-cigarette content (from real-life friends, online-only friends, and celebrities/influencers) on social media was associated with e-cigarette use vulnerabilities measured by perceived norms, perceived risk, and susceptibility of use, controlling for demographics, advertising exposure, and mental health conditions. Multiple imputations were performed to account for missing data.

RESULTS

Exposure to e-cigarette content on social media posted by real-life friends, online-only friends, and celebrities/influencers were associated with more positive descriptive norm (βs = 1.56, 0.37, and 0.35, respectively, all ps < .001), more positive injunctive norm (βs = 0.46, 0.19, and 0.10, respectively, all ps < .001), and higher odds of e-cigarette use susceptibility (ORs = 1.48, 1.50. 1.29, respectively, all ps < .001). Exposure to content posted by real-life and online-only friends were associated with reduced risk perception of e-cigarette use (β = -0.04, p < 0.05 and β = -0.07, p < 0.001).

CONCLUSIONS

Our study highlighted that friends and celebrities/influencers are important sources on social media that can influence youth non-users' vulnerabilities to e-cigarette use. Interventional messages communicated through friends and influencers on social media may in turn help reduce e-cigarette vulnerability among youth non-users.

Characteristics of Adolescents' and Young Adults' Exposure to and Engagement with Nicotine and Tobacco Product Content on Social Media

To inform policy and messaging, this study examined characteristics of adolescents' and young adults' (AYAs') exposure to and engagement with nicotine and tobacco product (NTP) social media (SM) content. In this cross-sectional survey study, AYAs aged 13-26 (N=1,163) reported current NTP use, SM use frequency, and exposure to and engagement with SM content promoting and opposing NTP use (i.e. frequency, source[s], format[s], platform[s]). Participants who used NTPs (vs. did not use) were more likely to report having seen NTP content (p-values<.001). Prevalent sources were companies/brands (46.6%) and influencers (44.4%); prevalent formats were video (65.4%) and image (50.7%). Exposure to content promoting NTP use was prevalent on several popular platforms (e.g. TikTok, Instagram, Snapchat); exposure to content opposing NTP use was most prevalent on YouTube (75.8%). Among those reporting content engagement (i.e. liking, commenting on, or sharing NTP content; 34.6%), 57.2% engaged with influencer content. Participants reported engaging with content promoting and opposing NTP use on popular platforms (e.g. TikTok, Instagram, YouTube). Participants with (versus without) current NTP use were significantly more likely to use most SM platforms and to report NTP content exposure and engagement (p-values<.05). Results suggest that NTP education messaging and enforcement of platforms' content restrictions are needed.

Advertising Exposure From Online and Offline Sources and Youth Tobacco Use: Findings From the Adolescents, Place, and Behavior Study

INTRODUCTION

Tobacco use among adolescents is an ongoing public health concern. Youth tobacco use has been associated with advertising, from both online sources and retail environments.

AIMS AND METHODS

This study examined associations between exposure to tobacco advertisements from tobacco retail outlets (TROs), internet, and social media sources and ever tobacco use among adolescents. Data were obtained from youth, aged 11-17 years (N = 401) from Richmond, VA. Bayesian index and group index models were fitted to estimate indices of exposure to (1) social media use, (2) tobacco ads on social media, and (3) TRO store visits and their association with ever tobacco use. The most important components of the exposure indices were also determined based on the index component weights from the Bayesian index models.

RESULTS

In Bayesian index models of single exposures, each exposure index was significantly associated with tobacco use. In the best-fitting model, social media tobacco ads (odds ratio [OR] = 2.2; 95% credible interval [CI]: 1.2, 4.5) and TRO store visits (OR = 1.6; 95% CI: 1.1, 2.3) were significantly associated with ever tobacco use, as was older age (OR = 1.4; 95% CI: 1.2, 1.8). Index component weights revealed Snapchat ad frequency as the most important platform in the social media index and convenience stores as the most important type of store in the TRO index.

CONCLUSIONS

Exposure to pro-tobacco advertisements on social media and visits to TROs are associated with adolescent ever tobacco use. Results provide support for policies that would restrict the promotion of tobacco products at TROs and on social media. Tobacco regulations and interventions targeting convenience stores and Snapchat may be warranted to reduce youth tobacco use.

IMPLICATIONS

Current evidence provide support for policies that would restrict the promotion of tobacco products at TROs and on social media. Findings suggest that regulations and interventions that specifically target advertisements in convenience stores and on Snapchat may be currently warranted to reduce youth tobacco use.

The mediating roles of mental health problems and racial differences in the linkage between social media use and E-cigarette use among American youth

OBJECTIVE

Social media use is shown to be linked to youth's e-cigarette use. However, less is known about the underlying mechanisms. This study examined the mediating roles of internalizing and externalizing problems in the association between youth's social media use and e-cigarette use, and the racial differences in the mediation association.

METHODS

The study sample included 4913 U.S. youth from the Population Assessment of Tobacco and Health Study Waves 3-5 (2015-2019). Two weighted generalized structural equation models were conducted to examine the mediation pathways between youth's social media use (Wave 3) and past-30-day e-cigarette use (Wave 5) through internalizing and externalizing problems (Wave 4), respectively. Invariance tests were conducted to examine racial group differences.

RESULTS

Youth with high social media use frequency were more likely to use e-cigarettes (total effect: OR = 1.20, p < 0.001 in both internalizing and externalizing models). Internalizing and externalizing problems mediated the aforementioned associations (mediation proportions: 5.05% and 5.66%, respectively). The invariance tests indicated a significant difference between White and non-White groups (both ps < 0.001), where a larger proportion of mediation was found in the non-White group (12.22% for internalizing and 11.99% for externalizing) compared to their White counterparts (2.46% for internalizing and 3.17% for externalizing).

CONCLUSIONS

Mental health problems following social media use served as a risk factor for e-cigarette use among youth. Interventions aiming to improve youth's mental health could in turn temper e-cigarette use among youth social media users, and implementing tailored interventions in response to racial differences is warranted.

How does health communication on social media influence e-cigarette perception and use? A trend analysis from 2017 to 2020

OBJECTIVE

E-cigarettes have achieved a high prevalence rapidly. While social media is among the most influential platforms for health communication, its impact on attitudes and behaviors of e-cigarettes and its changes over time remain underexplored. This study aims to address the gap.

METHODS

Four years of data (2017-2020) were derived from the U.S. Health Information National Trends Survey (HINTS) (aged 18-64 years, n = 9,914). Initially, key variables were compared across years. Furthermore, guided by the health belief model, we employed a moderated mediation model to examine the influence of social media health communication on the public's perceptions and behaviors related to e-cigarettes, distinguishing between smokers and non-smokers throughout the four-year period.

RESULTS

The evidence shows a process of dynamic interaction between communication, perception, and behavior. (1) We observed an increasing trend of social media health communication (SMH) and perceived relative harm of e-cigarettes (PHE). (2) Higher SMH was associated with more e-cigarette use directly in 2019. (3) Higher SMH was associated with less e-cigarette use indirectly through PHE in 2020. (4) Smokers consistently displayed heightened sensitivity in responding to harm perception compared to non-smokers.

CONCLUSIONS

The findings support two mechanisms underlying the association between SMH and e-cigarette use: direct and indirect. The changes in the pathways during the timespan may have been influenced by increased e-cigarette information on social media and public health events like COVID-19. Stricter regulations for unverified e-cigarette advertisements and anti-e-cigarette education on social media are called for to curtail e-cigarette use.

Associations between use of specific social media sites and electronic cigarette use among college students

OBJECTIVE

To examine dose-response associations between use of specific social media sites and the use of electronic cigarettes (e-cigarettes) and traditional cigarettes.

METHODS

This was a cross-sectional study of 298 first-year college students enrolled in the fall 2019 semester at a large state university. Heckman selection and Probit model were used to estimate associations between use of specific social media sites and e-cigarette/traditional cigarette use.

RESULTS

Each additional hour per day spent on Snapchat was associated with a 4.61% increase in the probability of lifetime e-cigarette use. In addition, among current e-cigarette users, more time spent on Snapchat was associated with more frequent e-cigarette use (marginal effects: 0.13, p = 0.001). Facebook, Twitter, Snapchat and Instagram were not associated with traditional cigarette smoking.

CONCLUSION

Snapchat was the only major social media platform associated with both lifetime and current e-cigarette use.

Cell phone use distracts young adults from academic work with limited benefit to self-regulatory behavior

We aim to uncover theoretical mechanisms associated with potential negative (i.e., multitasking) and positive (i.e., self-regulation) aspects of cell phone use (CPU) for academic performance in young adults. We hypothesized that, according to the Switch-Load Theory, repeated CPU during academic activities (CPU_Multitasking) would relate negatively, whereas, according to Zimmerman's Theory of Self-Regulated Learning, CPU for self-regulated learning behaviors (CPU_SRLBehavior) would relate positively to the academic performance of undergraduate students. 525 (75.4% female) undergraduate students from a large public university participated in this study during fall 2019 by completing validated quantitative surveys accessing their CPU and academic performance. Spearman's rho was used to compute the correlations and hierarchical regression was used to analyze the variance. Spearman rank-order coefficient showed that CPU_Multitasking relates negatively, but CPU_SRLBehavior is unrelated to the college GPA of undergraduate students. Hierarchical regression showed that CPU_Multitasking was not a significant predictor of academic performance. Young adults who switch to their cell phones during class or study-related activities are more likely to have lower performance in exams as CPU_Multitasking costs time and efficiency (Switch Load Theory). Young adults who use their cell phones for self-regulated learning behavior are less likely to have an impact on their academic performance as CPU_SRLBehavior helps regulate habits but not learning processes. With the known theoretical mechanisms for CPU multitasking and SRL Behavior, this study provides a guiding document for educational computing system practitioners to explore more theory-driven empirical approaches in the field of CPU and academic success.

Tech, Sex, and E-cigarettes: The Gendering of Vape Promotion on Instagram

The promotion of vape products on social media has been implicated in increasing rates of e-cigarette usage, particularly among youth and young adults. While research has examined overall trends in vape-related content across a number of platforms, the role that social media "influencers" play in promoting vaping and potentially augmenting this public health crisis has been insufficiently explored. The present study examined 44,052 Instagram posts by 60 male presenting and 60 female presenting vape influencers to understand how influencer gender mediates the performance of vape culture online. Our textual and visual analysis of these influencers' posts over one year revealed significant bifurcations based on gender. Independent sample t-tests showed statistically significant gender differences in word frequency. Male-presenting influencers tended to emphasize their expertise with vape devices as technologies, while female-presenting influencers tended to focus on their own appearance. Further, factor analysis indicated six major categories of textual features, and multiple linear regression tests showed varying levels of user engagement with the different categories across both genders. Chi-square tests indicated that female-presenting influencers highlighted their own bodies in the visual content of their posts, whereas male presenting influencers often posted images of vape devices or their component parts alone. These findings suggest that gender presentation plays an important role in shaping vape influencers' promotional tactics and vape-related content on Instagram, and also provides insights into what kinds of content receive the most user engagement. This study can therefore help inform interventions to mitigate the impact of social media vape promotion.

Preferences for Mobile-Supported e-Cigarette Cessation Interventions Among Young Adults: Qualitative Descriptive Study

Background

Despite the steady rise in electronic cigarette (e-cigarette) uptake among young adults, increasingly more young people want to quit. Given the popularity of smartphones among young adults, mobile-based e-cigarette cessation interventions hold significant promise. Smartphone apps are particularly promising due to their varied and complex capabilities to engage end users. However, evidence around young adults’ preferences and expectations from an e-cigarette cessation smartphone app remains unexplored.

Objective

The purpose of this study was to take an initial step toward understanding young adults’ preferences and perceptions on app-based e-cigarette cessation interventions.

Methods

Using a qualitative descriptive approach, we interviewed 12 young adults who used e-cigarettes and wanted to quit. We inductively derived themes using the framework analysis approach and NVivo 12 qualitative data analysis software.

Results

All participants agreed that a smartphone app for supporting cessation was desirable. In addition, we found 4 key themes related to their preferences for app components: (1) flexible personalization (being able to enter and modify goals); (2) e-cigarette behavior tracking (progress and benefits of quitting); (3) safely managed social support (moderated and anonymous); and (4) positively framed notifications (encouraging and motivational messages). Some gender-based differences indicate that women were more likely to use e-cigarettes to cope with stress, preferred more aesthetic tailoring in the app, and were less likely to quit cold turkey compared with men.

Conclusions

The findings provide direction for the development and testing of app-based e-cigarette cessation interventions for young adults.

Tobacco and cannabis use advertisements targeting adolescents and young adults on Snapchat in 2019

Social media platforms offer opportunities for targeted health communication ads to improve tobacco and cannabis prevention efforts. This study described tobacco and cannabis-related ads targeted towards adolescents and young adults on Snapchat. Data comprised of publicly available tobacco (n = 70) and cannabis-related (n = 64) ads from Snapchat in 2019. Identified themes included: Health consequences (Health effects of tobacco or cannabis use), Financial & legal consequences (Adverse financial or legal implications of substance use), Quitting (Resources for cessation), Industry tactics(Tobacco industry misleads individuals), Policy advocacy (Cannabis law reforms or legalization). Ad performance metrics included average Ad Impressions (number of views per ad) and Ad Spend (cost per ad). Ads were also categorized by Sponsoring Organizations (Government or Advocacy organizations). Health Consequences was the predominant theme followed by Quitting among tobacco-related ads. Government organizations sponsored most tobacco-related ads. Tobacco-related ads targeting adolescents received mean = 4,122,071 impressions and cost mean = $10,385.6 per ad. Tobacco-related ads targeting young adults received mean = 2,151,217 impressions and cost mean = $5,382.1 per ad. Health Consequences was a predominant theme among cannabis-related ads followed by Policy Advocacy. Advocacy organizations sponsored most cannabis-related ads targeting young adults. Cannabis-related ads targeting adolescents received mean = 415,293.8 impressions and cost mean=$793.92 per ad. Cannabis-related ads targeting young adults received mean = 293,267.7 impressions, and cost mean = $740.58. Government and advocacy organization sponsored ads reached millions of adolescents and young adults on Snapchat. Prevention campaigns may consider these number of impressions and cost per ad by theme when designing platform specific ads in the future.

The Influence of Social Media on the Treatment of Acne in Saudi Arabia

Objectives

The purpose of this study was to examine the effects of social media on acne treatment among the Saudi Arabian population.

Methods

This was a cross-sectional survey-based study conducted from January 2021 to August 2021. A self-administered survey was distributed through social media to different regions of Saudi Arabia. The survey obtained participants’ sociodemographic information and details on whether people used social media for advice on acne treatment. It also asked whether they noticed any change in their acne based on social media recommendations.

Results

Of the 5,539 respondents, 4,227 experienced acne, of which 1,793 were influenced by social media. Most respondents were women. The majority of social media users were between 18 and 25 years old and chose social media as their first approach for acne advice. The most commonly used platform was Instagram (34%). The most frequent social media recommendation chosen was to increase water intake. Many noticed a slight change in their acne (64%), and 14.9% had side effects. There was a significant association between the use of social media for advice and gender (p-value < 0.001), education level (p-value = 0.002), and severity of acne (p-value < 0.001).

Conclusion

Social media has an influence on acne treatment, with many advice not recommended by established guidelines. These findings imply that dermatologists should pinpoint inaccuracies resulting from advice found on social media.

Changes in Viewer Engagement and Accessibility of Popular Vaping Videos on TikTok: A 12-Month Prospective Study

AIM

There are concerns regarding what young people are exposed to on TikTok due to trending content promoting e-cigarette use through humour, marketing and lifestyle acceptability. Using baseline data from November 2020, we aimed to examine how much content from a sample of popular vaping videos remained accessible at 9- and 12-month follow-ups. We aimed to monitor changes in viewer engagement (using metadata) before and after the U.S. Congressional Hearing on youth protection measures on social media in October 2021.

METHODS

Hashtag-based keywords were used to collect the most viewed publicly available e-cigarette related videos on TikTok (N = 802) from inception to November 2020 to form a baseline. Researchers conducted a longitudinal descriptive study using this data, with 9- and 12-month follow-ups to measure changes in viewer engagement (using metadata) and content availability.

FINDINGS

Of the 802 videos from the baseline, 562 remained at the 9-month follow-up and 511 remained at the 12-month follow-up. At the 12-month follow-up, the majority of vaping-related hashtags were removed by TikTok after the Congressional Hearing. Between the baseline and 9-month follow up, views increased by 1.4% and likes increased by 4.4%. At 12-month follow-up, views had increased by 1.7% and likes by 4.2% compared to baseline data. Whilst 291 videos were no longer publicly accessible at 12-month follow-up, 39 of these were made inaccessible by the content creators. The most viewed and most liked vaping videos at baseline were still publicly available.

CONCLUSIONS

Whilst the depiction type and thematic distribution of removed videos suggest that TikTok may be removing a small proportion of content that promotes the use of e-cigarettes, metadata of remaining videos indicate an increase in viewer engagement. TikTok's removal of explicit substance-related hashtags from the platform could be a step towards preventing adolescents from being exposed to harmful behaviours and substances online. However, the platform should consider enforcing effective age restrictions on content that promotes substance use in a positive light.

Low Self-Control and Vaping: The Mediating Role of Health and Risk Perceptions

BACKGROUND

Research has shown independent attention in the role of self-control and health/risk perceptions toward vaping in predicting vaping use among youth and young adults. Yet, there are good theoretical notions to believe that low self-control, perceptions toward vaping, and self-reported vaping are intertwined.

OBJECTIVES

To examine whether three different health/risk perceptions toward vaping mediate the effect of low self-control on vaping use among young adults.

METHODS

A survey was administered to 325 undergraduate students attending a large university in the Midwest (Mean age = 19.5; 60.4% female; 73.1% White). Single and multiple mediation modeling strategies were used to assess the mediation hypothesis.

RESULTS

Logistic regression results indicate that individuals with low self-control are more likely to vape (O.R. = 1.041, p < .05). Further, when health/risk perceptions are included in the models individually and simultaneously, it reduces the effect of low self-control on vaping between 15% and 37.5%, and renders low self-control to become non-significant.

CONCLUSIONS

Findings suggest the impact that harm/risk perceptions toward vaping have in engaging in this behavior. Thus, preventative efforts should target potential sources, such as media and advertisements, that may shape young adults' perceptions toward vaping.

Exposure to e-cigarette content on social media and e-cigarette use: An ecological momentary assessment study

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Exposure to e-cigarette content on social media may affect behavior in the real-time.

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Exposure to anti-e-cigarette content may have a lagged effect on behavior.

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Exposure to pro-e-cigarette content may have a more immediate effect on behavior.

This pilot ecological momentary assessment (EMA) study tested the associations between exposure to anti-e-cigarette content on social media and e-cigarette use behavior. For exposure to anti-e-cigarette posts, participants were asked to follow the study account on Instagram, on which anti-e-cigarette content were posted regularly. In addition, we assessed participants’ exposure to pro-e-cigarette content in their daily lives and examined the effects of such exposure on behavior. Participants were 29 diverse young adult current e-cigarette users (18–30 year olds; 54% women), who provided data 3 times daily, for 3 weeks via a mobile phone based EMA application. Relative to no exposure, exposure to anti-e-cigarette content was associated with decreased recent e-cigarette use frequency at the next assessment time-point (p < 0.05; 2-tailed). In addition, a statistically significant concurrent association was found between exposure to pro-e-cigarette content (relative to no exposure) and higher e-cigarette use (p < 0.05; 2-tailed). The current data are some of the first to show that exposure to anti-e-cigarette content on social media may have real time effects on decreased e-cigarette use among young adults as they go about their daily lives. Policies and efforts designed to regulate pro-e-cigarette and promote anti-e-cigarette content on social media may help reduce e-cigarette use among young people.

Correlates of tobacco use among Asian and Pacific Islander youth and young adults in the U.S.: A systematic review of the literature

Rates of tobacco product use, including the use of combustible and electronic cigarettes, remain high in youth and young adults within the U.S. Though a substantial body of work has examined risk factors associated with initiation and ongoing use of tobacco products, research on tobacco use and associated correlates among Asian and Pacific Islanders (APIs) has been more limited despite high rates in select API subgroups. This systematic review outlines recent research (2010-2020) on the correlates of tobacco use in APIs aged 9-29. To better understand determinants of tobacco use and identify gaps in the literature, we framed correlates based on the National Institute on Minority Health and Health Disparities (NIMHD) multidimensional research framework. Database and author-focused searches were conducted, followed by article abstract and full-text reviews, much of which were guided by a discrete set of inclusionary and exclusionary criteria related to tobacco use and youth/young adults. A total of 24 articles were included in this review. The majority of articles focused on individual-level correlates, with a high number of studies demonstrating association between behavioral and sociocultural factors and tobacco product use behavior. Interpersonal factors also made up a substantial portion of the literature, commonly focusing on peer, family, and social norms. Gaps related to the NIMHD model are addressed. Future research should examine biological and community/societal factors associated with API smoking to better understand unique correlates in this population and to inform tobacco prevention and intervention approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social media and E-cigarette use among US youth: Longitudinal evidence on the role of online advertisement exposure and risk perception

OBJECTIVES

Previous studies revealed a link between social media use and e-cigarette use among U.S. youth, but less is known about the mechanisms through which they interconnect. This study examined how social media and e-cigarette use are connected through online advertisement exposure and risk perception of e-cigarettes among U.S. youth.

METHODS

Youth aged 12-17 from the Public Assessment of Tobacco and Health (PATH) Study Waves 2-4 (2014-2018) were included (N = 6,208). This study integrated the incidental exposure framework and the risk perception framework to guide study conceptualization and variable selection. Generalized structural equation modeling was performed to investigate the sequential mediation relationship between social media and e-cigarette use through online e-cigarette advertisement exposure and risk perception of e-cigarette use.

RESULTS

Youth respondents with more social media use were more likely to be exposed to e-cigarette advertisement at Wave 2 (OR = 1.13, p < 0.001), which led to lower e-cigarette risk perception at Wave 3 (β = -0.07, p < 0.001). Higher e-cigarette risk perception at Wave 3 resulted in lower likelihood of e-cigarette use at Wave 4 (OR = 0.57, p < 0.001). High social media use at Wave 2 was directly associated with high likelihood of e-cigarette use at Wave 4 (OR = 1.11, p < 0.001).

CONCLUSIONS

The results indicate that social media use is associated with increased e-cigarette use through online e-cigarette advertisement exposure and subsequently decreased e-cigarette risk perception among U.S. youth. Our findings underscore the importance of regulating online e-cigarette advertisement, with the emphasis of avoiding information that could twist youth's risk perception of e-cigarettes, which may in turn curtail youth e-cigarette use.

A synthesis of the literature to inform vaping cessation interventions for young adults

There is an urgent need to address young adult (YA) vaping. However, there is limited vaping cessation intervention research, particularly studies tested via experimental designs. This manuscript focuses on YA vaping and critical needs for research to advance vaping cessation interventions for YAs. The smoking cessation literature, especially regarding YA smoking, provides evidence and theory from which to draw. However, the extent to which this literature has utility for vaping cessation warrants investigation. Research to inform the development and optimization of effective vaping cessation interventions for YAs requires attention to both potential targets for behavioral intervention (e.g., conceptual framework) and how to best reach YAs (i.e., delivery modality). Regarding the former, such interventions must consider the complexity of YA vaping (e.g., complex social influences, limited negative outcome expectancies, quit intentions). One particularly challenging aspect of YA cessation is co-use of other tobacco products and marijuana and ensuring that those who quit vaping do not continue or increase other product use. With regard to intervention modality, technology-based interventions (e.g., text messaging, apps) may prove promising, and individualized intervention (e.g., one-on-one counseling) may be needed to carefully intervene on the complexity of substance use, particularly cigarette and marijuana use, within this population.

Social media use in patients with acne vulgaris: What do patients expect from social media?

BACKGROUND

Acne vulgaris (AV) may affect external appearance and significantly deteriorate the quality of life of patients. Therefore, patients make various inquiries about their disease and seek treatment options.

AIMS

To investigate the social media usage habits of patients with AV concerning their diseases, and their recommendations for dermatologists related to social media use.

METHODS

A total of 1609 patients with AV completed the survey prepared by the authors and the Cardiff Acne Disability Index questionnaire. The Food and Drug Administration severity scores and clinical information of the patients were noted by their physicians.

RESULTS

Of the 1,489 patients who stated that they used social media, 46.31% regularly and 28.77% sometimes referred to these sources to make inquiries about AV. Social media usage for AV was statistically significantly higher in women, participants with short term and severe disease, those with a moderate income level, and those using topical treatment and cosmetics. They mostly used Google (67%), Instagram (54%), and YouTube (49%). While 76% of the participants stated that they did not share what they saw on the Internet with their doctor. Of the respondents, 18.5% were trying to contact their dermatologists through the Internet, and 69.73% would prefer experts such as dermatologists to post-AV-related content.

CONCLUSIONS

Our study shows that patients frequently resort to social media to seek information about AV. In the changing digital world order, it is observed that there is a need for dermatologists to use social media more actively to share accurate information about AV.

Association Between Social Media Use and Vaping Among Florida Adolescents, 2019

INTRODUCTION

With the growing popularity of vaping, evidence has emerged about the association between social media use and vaping among adolescents, possibly because of the proliferation of e-cigarette advertisements and other related content on social media. Our study examined the association between social media use and vaping among adolescents.

METHODS

Using data from the 2019 Florida Youth Tobacco Survey (N = 10,776), we conducted logistic regression models on adolescent vaping status (experimental and current vaping) by nondaily and daily use of social media platforms - Facebook, Instagram, Twitter and Snapchat, controlling for other confounders.

RESULTS

Use of all 4 selected social media platforms was significantly associated with vaping status (P <.001 for all). Once jointly analyzed, daily use of Instagram was significantly associated with increased relative risks of experimental (adjusted relative risk ratio [aRRR] = 1.76; 95% CI, 1.38-2.25) and current vaping (aRRR = 1.51; 95% CI, 1.16-1.95); nondaily use of Snapchat was significantly associated with increased relative risk of experimental (aRRR = 1.57; 95% CI, 1.17-2.10) and current vaping (aRRR = 1.87; 95% CI, 1.31-2.66); daily use of Snapchat was associated with increased relative risk of experimental (aRRR = 2.38; 95% CI, 1.85-3.08) and current vaping (aRRR = 5.09; 95% CI, 3.78-6.86); nondaily use of Facebook was associated with increased relative risk of current vaping (aRRR = 1.20; 95% CI, 1.00-1.43), and nondaily use of Twitter was associated with increased relative risk of current vaping (aRRR = 1.29; 95% CI, 1.07-1.56).

CONCLUSION

Multilevel efforts are warranted to monitor social media use and vaping status among adolescents, including media use monitoring plans, developing counter-marketing campaigns, and strict regulatory action on social media.

Associations between Self-Reports and Device-Reports of Social Networking Site Use: An Application of the Truth and Bias Model

People are generally poor reporters of time spent using digital technology. Advancing smartphone features, such as the iOS Screen Time application, allow researchers to obtain more objective measurements of digital technology use. Truth and Bias models were used to test how self-reported social networking site use aligns with device-reported use as recorded by the iOS Screen Time app (N=1585). This study explored use across four major platforms (Facebook, Instagram, Twitter, Snapchat) and examined how individual differences moderate biases in reports. Participants overestimated their use for all platforms at comparable levels. Moderation by individual differences was not consistent. These findings add to the growing call from researchers to utilize assessments other than self-reports in measuring digital technology use.

Identifying current Juul users among emerging adults through Twitter feeds

INTRODUCTION

Juul is the most popular electronic cigarette on the market. Amid concerns around uptake of e-cigarettes by never smokers, can we detect whether someone uses Juul based on their social media activities? This is the central premise of the effort reported in this paper. Several recent social media-related studies on Juul use tend to focus on the characterization of Juul-related messages on social media. In this study, we assess the potential in using machine learning methods to automatically identify Juul users (past 30-day usage) based on their Twitter data.

METHODS

We obtained a collection of 588 instances, for training and testing, of Juul use patterns (along with associated Twitter handles) via survey responses of college students. With this data, we built and tested supervised machine learning models based on linear and deep learning algorithms with textual, social network (friends and followers), and other hand-crafted features.

RESULTS

The linear model with textual and follower network features performed best with a precision-recall trade-off such that precision (PPV) is 57 % at 24 % recall (sensitivity). Hence, at least every other college-attending Twitter user flagged by our model is expected to be a Juul user. Additionally, our results indicate that social network features tend to have a large impact (positive) on classification performance.

CONCLUSION

There are enough latent signals from social feeds for supervised modeling of Juul use, even with limited training data, implying that such models are highly beneficial to very focused intervention campaigns. This initial success indicates potential for more involved automated surveillance of Juul use based on social media data, including Juul usage patterns, nicotine dependence, and risk awareness.