Son, you’re smoking on Facebook! College students’ disclosures on social networking sites as indicators of real-life risk behaviors

Which Social Media Platforms Provide the Most Informative Data for Monitoring the Opioid Crisis?

Background and Aims

Social media can provide real-time insight into trends in substance use, addiction, and recovery. Prior studies have leveraged data from platforms such as Reddit and X (formerly Twitter), but evolving policies around data access have threatened their usability in opioid overdose surveillance systems. Here, we evaluate the potential of a broad set of platforms to detect emerging trends in the opioid crisis.

Design

We identified 72 online platforms with a substantial global user base or prior citations in opioid-related research. We evaluated each platform's fit with our definition of social media, size of North American user base, and volume of opioid-related discourse. We created a shortlist of 11 platforms that met our criteria. We documented basic characteristics, volume and nature of opioid discussion, official policies regulating drug-related discussion, and data accessibility of shortlisted platforms.

Setting

USA and Canada.

Measurements

We quantified the volume of opioid discussion by number of platform-specific Google search hits for opioid terms. We captured informal language by including slang generated using a large language model. We report the number of opioid-related hits and proportion of opioid-related hits to hits for common nouns.

Findings

We found that TikTok, YouTube, and Facebook have the most potential for use in opioid-related surveillance. TikTok and Facebook have the highest relative amount of drug-related discussions. Language on TikTok was predominantly informal. Many platforms offer data access tools for research, but changing company policies and user norms create instability. The demographics of users varies substantially across platforms.

Conclusions

Social media data sources hold promise for detecting trends in opioid use, but researchers must consider the utility, accessibility, and stability of data on each platform. A strategy mixing several platforms may be required to cover all demographics suffering in the epidemic.

Time spent on social media and depressive symptoms in university students: The mediating role of psychoactive substances

BACKGROUND AND OBJECTIVES

Although some studies have related social media use and depressive symptoms, little is known about the role of psychoactive substance use in this relationship. Therefore, this study aimed to estimate the association between time spent on social media (TSSM) and depressive symptoms and to examine whether this relationship is mediated by psychoactive substances in students.

METHODS

Our cross-sectional analysis included a sample of students from a university in a large city in southern Brazil. The TSSM and tobacco frequency of consumption were self-reported. Depressive symptoms were assessed with the Patient Health Questionnaire. Alcohol and illicit drug-related risks were assessed with the Alcohol, Smoking and Substance Involvement Screening Test. Hayes's PROCESS macro was used for mediation analyses, adjusted for age, sex, body mass index and physical activity.

RESULTS

A total of 3161 students were included, of which, 69.0% reported moderate to severe depressive symptoms. The association between TSSM and depressive symptoms was statistically significant and partially mediated by tobacco consumption (indirect effect [IE] = 0.05; 95% CI: 0.02-0.08), alcohol-related risk (IE = 0.19; 95% CI: 0.14-0.25), and illicit drug-related risk (IE = 0.08; 95% CI: 0.05-0.12).

CONCLUSION AND SCIENTIFIC SIGNIFICANCE

Our data suggest a direct relationship between TSSM and depressive symptoms, with a partial mediation effect of psychoactive substance use. This study highlights the importance that public health initiatives aimed at preventing depressive problems in young adults should focus not only on TSSM, but also on controlling and reducing psychoactive substance use.

Coping and Conformity Motives Mediate the Joint Effects of the Behavioral Inhibition and Approach Systems on Alcohol Problems in Young Adults

Background: Gray's original Reinforcement Sensitivity Theory (RST) posits that an oversensitive behavioral inhibition system (BIS) may increase risk for negative-reinforcement-motivated drinking, given its role in anxiety. However, existing data provides mixed support for the BIS-alcohol use association. The inconsistent evidence is not surprising, as the revised RST predicts that the behavioral approach system (BAS) should moderate the effect of the BIS on alcohol use. A strong BAS is thought to bring attention to the negatively reinforcing effects of alcohol, leading to problem drinking among those with a strong BIS. While emerging results support this interaction, we still have much to learn about the mechanisms underlying this effect on alcohol use. Accordingly, we examined motives for alcohol use as mediators of the joint associations of the BIS and the BAS on drinking behaviors. Specifically, our central hypothesis was that individuals with a strong BIS and a strong BAS would endorse increased negative reinforcement motives for drinking (coping and conformity motives), which in turn would predict heavy drinking and alcohol problems. Method: Participants (N=346; 195 women) completed study measures as part of the baseline assessment for a larger study. Results: Overall, results partially supported the hypotheses. Mediated moderation analyses showed that the indirect effect of the BIS on alcohol problems, through coping and conformity motives, was strongest at high levels of the BAS. This effect was not supported for alcohol use. Conclusions: Our findings suggest that clinical interventions should target coping and conformity reasons for drinking among anxious, reward responsive, young adults.

Sharing pro-marijuana messaging on social media: The moderating role of legislation

ObjectivesThis study investigates whether recreational marijuana legislation and perceived social norms (descriptive and injunctive) affect college students' propensity to share pro-marijuana messages. We examine which referent group (close friends, typical student, parents) most influence those norms. Participants: A sample of 343 college students participated in the study. Of these students, 214 were from Washington State, where recreational marijuana is legal, and 129 were from Wyoming, where recreational marijuana is illegal. Method: Data, from an online survey, were analyzed through PROCESS analyses. Results: College students in Washington State who believed a typical peer would want them to share pro-marijuana messaging were marginally more likely to share pro-marijuana messages than their counterparts in Wyoming. However, among students who thought a typical peer would not approve of them sharing pro-marijuana messaging, the opposite pattern emerged. Conclusion: Restrictive recreational marijuana legislation does not uniformly abate related message sharing on social media.

“#BingeDrinking: Using Social Media to Understand College Binge Drinking (Preprint)

Background

Objective

Methods

Results

Conclusions

Causal Effects of Alcohol-Related Facebook Posts on Drinking Behavior: Longitudinal Experimental Study

Background

Adolescents and young adults frequently post alcohol-related content (ie, alcoholposts) on social media. This is problematic because both social norms theory and social learning theory suggest that viewing alcoholposts of peers could increase drinking behavior. It is therefore paramount to understand the effects of exposure to alcoholposts on viewers.

Objective

This study aimed to investigate the causal effects of exposure to alcoholposts on alcohol consumption by using a rigorous design.

Methods

We conducted a 6-week longitudinal study during which alcoholposts were measured by a newly developed app that copied Facebook posts shared by participants (n=281) to a new social media environment. In addition, daily questionnaires assessed alcohol use. Effects of natural alcoholposts (ie, posted by the participants) were assessed in phase 1, and effects of experimental posts (ie, posted by fake participants) were explored in phase 2.

Results

Results showed that natural alcoholposts increased the occurrence and quantity of drinking the following day. That is, exposure to a single additional alcoholpost increased the log odds of drinking the next day by 0.27 (b=.27, credible interval [CI] .18 to .35). Furthermore, the number of natural alcoholposts had a positive (predictive) effect on the number of glasses drunk the next day (b=.21, CI .14 to .29). In phase 2 when experimental posts were also present, these effects decreased. Experimental posts themselves had hardly any effects.

Conclusions

This study illustrates clear and direct effects of exposure to alcoholposts on next-day alcohol consumption and suggests that alcoholposts represent an important societal problem that interventions need to address.

The Exploration of How Social Media Cultivate College Student Smokers: Theorizing Valence of Communication, Impression Management, and Perceived Risks and Benefits of Smoking in the O1-S-R1-O2-R2 Model

The purpose of this study is to build a theoretical framework to account for how social media lead college students to smoke. Arguing critical concepts, such as valence of communication, impression management, perceived risks and benefits, this study develops the O 1 -S-R 1 -O 2 -R 2 model. For this, we test a separated model for smokers and nonsmokers. For smokers, the effect of exposure to pro-smoking content on smoking behavior is mediated by an impression of smokers, a favorable expression about smoking, and perceived benefits. And, the effect of exposure to anti-smoking content on smoking behavior is mediated by an unfavorable expression about smoking and perceived risks. However, such mediation processes cannot be observed for nonsmokers; namely, the effect of exposure to pro-smoking content on smoking intention is only mediated by a favorable expression about smoking. Considering the separated path models for smokers and nonsmokers, theoretical and practical implications are suggested for future study. Methodological limitations are discussed as well.

Perceptions surpass reality: Self-reported alcohol-related communication on Instagram is more strongly related with frequency of alcohol consumption and binge drinking than actual alcohol-related communication

Mounting research finds that sharing alcohol references on social media is related to higher levels of alcohol consumption. The present study aims to improve our understanding of potential biases when using self-report measures, to provide more insight in the differences between background and foreground alcohol references, and to examine different drinking patterns. We examined the Instagram profiles of 128 Belgian college students (M_age = 21.31, SD = 1.50; 64.8 % women) and compared how the observed number of pictures depicting alcohol in the background or in the foreground as well as self-reports on their frequency of sharing alcohol-related content was associated with frequency of alcohol consumption, typical quantity consumed and frequency of binge drinking. Results demonstrated that self-reported frequency of sharing alcohol references and observed number of alcohol-in-the-foreground references were positively related to participants' alcohol consumption. However, self-reports were a stronger predictor of alcohol consumption than alcohol-in-the-foreground references, and were most strongly related to binge drinking. Alcohol-in-the-background references were not significant. This means that the relationship between sharing alcohol posts and drinking behavior is overinflated in studies relying solely on self-report data.

Temporal, Sex-Specific, Social Media-Based Alcohol Influences during the Transition to College

The transition to college is an important developmental phase, usually met with increased social desirability, access to alcohol, and new peer groups. Recently, research has utilized social media as a predictor of events during college, but few have assessed how social media can influence alcohol use during the transition to college. Methods: Participants (N = 320) were recruited prior to entering their first year of college. Participants were 18 years old, 60.7% were women, with 46.3% identifying as White, 16.5% Hispanic, 14.9% Asian, 9.5% Black, and 7.6% other. Each participant was assessed three times: prior to matriculation, first semester, and second semester of their freshman year. We assessed the effect of exposure to alcohol content via social media on long-term trajectories of alcohol use. We also assessed self-reported sex as a moderator. Results: Exposure to alcohol content (over and above one's own posting of alcohol content) was associated with greater frequency of drinking during the transition to college. In the multi-group model, exposure to alcohol content was associated with greater drinking prior to matriculation for men. However, for women, exposure to alcohol content was associated with greater alcohol use in the first semester of college. Conclusion: Our results indicate exposure to alcohol-related media content is a strong predictor, over and above one's own positing, of increased drinking, and this effect varies by sex and point in time. Our results lend support for more tailored and time-specific prevention programming for incoming freshmen that should integrate social media normative feedback.

Mining Social Media Data for Biomedical Signals and Health-Related Behavior

Social media data have been increasingly used to study biomedical and health-related phenomena. From cohort-level discussions of a condition to population-level analyses of sentiment, social media have provided scientists with unprecedented amounts of data to study human behavior associated with a variety of health conditions and medical treatments. Here we review recent work in mining social media for biomedical, epidemiological, and social phenomena information relevant to the multilevel complexity of human health. We pay particular attention to topics where social media data analysis has shown the most progress, including pharmacovigilance and sentiment analysis, especially for mental health. We also discuss a variety of innovative uses of social media data for health-related applications as well as important limitations of social media data access and use.

Linguistic Predictors of Problematic Drinking in Alcohol-related Facebook Posts

Emerging adults often increase problematic drinking during college. Although they generally do not seek help for problematic drinking, college students discuss their drinking on social media. This study followed college students' Facebook profiles from the inception of their attendance at a university and identified alcohol-related posts. Within 28 days of their first alcohol-related Facebook post, participants were interviewed to assess problematic drinking (binge drinking episodes and number of drinks). Linguistic analysis of alcohol-related Facebook posts found that use of negative emotion language and swear words were related to problematic drinking, in support of proposed hypotheses. Results are situated within alcohol use disorder and health research examining the link between problematic drinking and anxiety, deviant behavior, and negative emotions.

The Role of Social Media Content on Solitary Drinking Among Korean Adults

This study aims to provide explanations for how exposure to social media content on solitary drinking influences the frequency and quantity of solitary drinking, and posting about solitary drinking on social networking sites (SNS). An online survey was conducted with 506 Korean adults who had consumed alcohol at least once while alone in the previous year. The study showed the following results: First, exposure to social media content related to solitary drinking was positively associated with both descriptive norms and negative alcohol expectancies, both of which increased solitary drinking and posting on SNS. Second, although social media content influenced injunctive norm perceptions, injunctive norms did not influence solitary drinking or posting on SNS. Findings suggest that correcting descriptive norms on solitary drinking may be an appropriate intervention for solitary alcohol users in Korea.

Self-Persuasion on Facebook Increases Alcohol Risk Perception

In this experiment, we examined if participating in a Facebook group by generating antialcohol arguments (self-persuasion) is more effective than reading antialcohol posts of others (direct persuasion) in changing alcohol consumption, risk perception, and attitudes. In addition, it was examined if submitting posts moderated these effects. Participants logged into their Facebook account and joined a group that contained posts with antialcohol arguments. They either generated their own arguments with or without posting them, or read those present in the group with or without posting that they had read them. Next, participants rated movie clips in a 30-minute ad libitum drinking session in dyads, and their alcohol consumption was measured. Finally, measures of alcohol risk perception and attitudes were completed. Results show that generating antialcohol arguments-regardless of whether they are posted online-is effective in increasing alcohol risk perception but does not affect immediate alcohol consumption.

Alcoholposts on Social Networking Sites: The Alcoholpost-Typology

Young people frequently display alcohol-related posts ("alcoholposts") on social networking sites such as Facebook and Instagram. Although evidence exists that such posts may be linked with increases in alcohol consumption, hardly any studies have focused on the content of such posts. This study addresses this gap by applying and extending the alcoholpost-typology previously proposed by Hendriks, Gebhardt, and van den Putte. A content analysis assessed the extent to which alcoholposts were displayed on Facebook and/or Instagram profiles of young participants (12-30 years; N = 192), and which type of alcoholpost these posts most strongly resembled. Moderate alcoholposts (e.g., in which alcohol was in the background) were most often posted. At times, textual alcoholposts and commercial alcoholposts were also displayed; however, extreme posts (e.g., about drunk people or drinking-games) were almost nonexistent. These findings confirm the previous results by Hendriks et al. that moderate posts are more frequently posted than extreme posts. This could imply that positive associations with alcohol consumption are more visible on social media than negative associations, potentially leading to an underestimation of alcohol-related risks.

Social Drinking on Social Media: Content Analysis of the Social Aspects of Alcohol-Related Posts on Facebook and Instagram

Background

Alcohol is often consumed in social contexts. An emerging social context in which alcohol is becoming increasingly apparent is social media. More and more young people display alcohol-related posts on social networking sites such as Facebook and Instagram.

Objective

Considering the importance of the social aspects of alcohol consumption and social media use, this study investigated the social content of alcohol posts (ie, the evaluative social context and presence of people) and social processes (ie, the posting of and reactions to posts) involved with alcohol posts on social networking sites.

Methods

Participants (N=192; mean age 20.64, SD 4.68 years, 132 women and 54 men) gave researchers access to their Facebook and/or Instagram profiles, and an extensive content analysis of these profiles was conducted. Coders were trained and then coded all screenshotted timelines in terms of evaluative social context, presence of people, and reactions to post.

Results

Alcohol posts of youth frequently depict alcohol in a positive social context (425/438, 97.0%) and display people holding drinks (277/412, 67.2%). In addition, alcohol posts were more often placed on participants’ timelines by others (tagging; 238/439, 54.2%) than posted by participants themselves (201/439, 45.8%). Furthermore, it was revealed that such social posts received more likes (mean 35.50, SD 26.39) and comments than nonsocial posts (no people visible; mean 10.34, SD 13.19, P<.001).

Conclusions

In terms of content and processes, alcohol posts on social media are social in nature and a part of young people’s everyday social lives. Interventions aiming to decrease alcohol posts should therefore focus on the broad social context of individuals in which posting about alcohol takes place. Potential intervention strategies could involve making young people aware that when they post about social gatherings in which alcohol is visible and tag others, it may have unintended negative consequences and should be avoided.

Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults

Despite the pervasive use of social media by young adults, there is comparatively little known about whether, and how, engagement in social media influences this group's drinking patterns and risk of alcohol-related problems. We examined the relations between young adults' alcohol-related social media engagement (defined as the posting, liking, commenting, and viewing of alcohol-related social media content) and their drinking behavior and problems. We conducted a systematic review and meta-analysis of studies evaluating the association of alcohol consumption and alcohol-related problems with alcohol-related social media engagement. Summary baseline variables regarding the social media platform used (e.g., Facebook and Twitter), social media measures assessed (e.g., number of alcohol photographs posted), alcohol measures (e.g., Alcohol Use Disorders Identification Test and Timeline Follow back Interview), and the number of time points at which data were collected were extracted from each published study. We used the Q statistic to examine heterogeneity in the correlations between alcohol-related social media engagement and both drinking behavior and alcohol-related problems. Because there was significant heterogeneity, we used a random-effects model to evaluate the difference from zero of the weighted aggregate correlations. We used metaregression with study characteristics as moderators to test for moderators of the observed heterogeneity. Following screening, 19 articles met inclusion criteria for the meta-analysis. The primary findings indicated a statistically significant relationship and moderate effect sizes between alcohol-related social media engagement and both alcohol consumption (r = 0.36, 95% CI: 0.29 to 0.44, p < 0.001) and alcohol-related problems (r = 0.37, 95% CI: 0.21 to 0.51, p < 0.001). There was significant heterogeneity among studies. Two significant predictors of heterogeneity were (i) whether there was joint measurement of alcohol-related social media engagement and drinking behavior or these were measured on different occasions and (ii) whether measurements were taken by self-report or observation of social media engagement. We found moderate-sized effects across the 19 studies: Greater alcohol-related social media engagement was correlated with both greater self-reported drinking and alcohol-related problems. Further research to determine the causal direction of these associations could provide opportunities for social media-based interventions with young drinkers aimed at reducing alcohol consumption and alcohol-related adverse consequences.

Disclosure and Exposure of Alcohol on Social Media and Later Alcohol Use: A Large-Scale Longitudinal Study

This article aims to investigate whether alcohol-related disclosure and exposure on social media can predict later alcohol use, and to identify covariates in these relationships. Data were collected by online surveys (two waves) among students in Bergen, Norway. The first survey was administered in fall 2015. The follow-up took place during fall 2016. A total of 5,217 students participated in both waves. The surveys included questions about demographics, personality, alcohol use, alcohol-related cognitions (e.g., attitudes and norms), social media use, and disclosure and exposure of alcohol on social media. Bivariate comparisons were conducted to assess differences in alcohol use between the frequent (i.e., monthly or more often) disclosure and exposure groups and low-frequent disclosure and exposure groups. Crude and adjusted linear regressions were employed to investigate if disclosure and exposure of alcohol could predict later alcohol use, when controlling for a range of covariates. Compared to the low-frequent disclosure and exposure groups, participants which frequently disclosed or were frequently exposed to alcohol-related content had higher alcohol use at baseline and 1 year later (p < 0.001), when no covariates were controlled for. Frequent disclosure of content reflecting positive aspects of alcohol predicted stable or slightly increased alcohol use at Time 2 (p < 0.01), even when all covariates (i.e., demographics, personality, alcohol use, alcohol-related cognitions, and social media use) were controlled for. In conclusion, frequent disclosure and/or exposure to alcohol-related content predicted alcohol use over time. Alcohol disclosure/exposure on social media could for the most part not predict later alcohol use when baseline alcohol use was controlled for. High alcohol use and alcohol disclosure/exposure on social media appear to be strongly intertwined, which hampers identification of directionality between alcohol use and disclosure/exposure. Disclosing content reflecting positive aspects of alcohol was the only independent variable that could predict further alcohol use when other factors, like baseline alcohol use, were held constant. This finding suggests that disclosure of alcohol content reflecting positive aspects of alcohol might have a self-enhancing effect on the sharers' further alcohol consumption, or that disclosing such content could indicate lenient alcohol-related cognitions not detected by the current measurements.

Scaling Up Research on Drug Abuse and Addiction Through Social Media Big Data

Background

Substance use–related communication for drug use promotion and its prevention is widely prevalent on social media. Social media big data involve naturally occurring communication phenomena that are observable through social media platforms, which can be used in computational or scalable solutions to generate data-driven inferences. Despite the promising potential to utilize social media big data to monitor and treat substance use problems, the characteristics, mechanisms, and outcomes of substance use–related communications on social media are largely unknown. Understanding these aspects can help researchers effectively leverage social media big data and platforms for observation and health communication outreach for people with substance use problems.

Objective

The objective of this critical review was to determine how social media big data can be used to understand communication and behavioral patterns of problematic use of prescription drugs. We elaborate on theoretical applications, ethical challenges and methodological considerations when using social media big data for research on drug abuse and addiction. Based on a critical review process, we propose a typology with key initiatives to address the knowledge gap in the use of social media for research on prescription drug abuse and addiction.

Methods

First, we provided a narrative summary of the literature on drug use–related communication on social media. We also examined ethical considerations in the research processes of (1) social media big data mining, (2) subgroup or follow-up investigation, and (3) dissemination of social media data-driven findings. To develop a critical review-based typology, we searched the PubMed database and the entire e-collection theme of “infodemiology and infoveillance” in the Journal of Medical Internet Research / JMIR Publications. Studies that met our inclusion criteria (eg, use of social media data concerning non-medical use of prescription drugs, data informatics-driven findings) were reviewed for knowledge synthesis. User characteristics, communication characteristics, mechanisms and predictors of such communications, and the psychological and behavioral outcomes of social media use for problematic drug use–related communications are the dimensions of our typology. In addition to ethical practices and considerations, we also reviewed the methodological and computational approaches used in each study to develop our typology.

Results

We developed a typology to better understand non-medical, problematic use of prescription drugs through the lens of social media big data. Highly relevant studies that met our inclusion criteria were reviewed for knowledge synthesis. The characteristics of users who shared problematic substance use–related communications on social media were reported by general group terms, such as adolescents, Twitter users, and Instagram users. All reviewed studies examined the communication characteristics, such as linguistic properties, and social networks of problematic drug use–related communications on social media. The mechanisms and predictors of such social media communications were not directly examined or empirically identified in the reviewed studies. The psychological or behavioral consequence (eg, increased behavioral intention for mimicking risky health behaviors) of engaging with and being exposed to social media communications regarding problematic drug use was another area of research that has been understudied.

Conclusions

We offer theoretical applications, ethical considerations, and empirical evidence within the scope of social media communication and prescription drug abuse and addiction. Our critical review suggests that social media big data can be a tremendous resource to understand, monitor and intervene on drug abuse and addiction problems.

Alcohol-Related Posts from Young People on Social Networking Sites: Content and Motivations

Many young people place alcohol-related posts on social networking sites (SNS) which can result in undesirable effects. Although several recent studies have investigated the occurrence of alcohol-related SNS use, it is neither clear (a) what type of alcohol posts are placed on SNS, (b) the motivations to place alcohol posts, nor (c) which young people are most likely to place alcohol posts. This study addressed these three goals. A large cross-sectional study among young participants (12-30 years; N = 561) assessed the posting of different types of alcohol posts, the motivations to (not) post these posts, and potential differences in posting between subgroups (i.e., in terms of age, gender, and religion). Participants reported that they most often placed moderate, instead of more extreme, alcohol posts, in particular, when alcohol was present in the post "by chance". Furthermore, they indicated to post alcohol-related content mostly for entertainment reasons. Finally, we found differences in self-reported posting and motivations to post according to age, gender, and religion. These findings provide relevant implications for future interventions aiming to decrease alcohol posts, for example, by making participants aware of their posting behavior and by targeting specific at risk groups. Future research should explore the effectiveness of such intervention strategies and should investigate whether alcohol posts lead to an underestimation of alcohol-related risks.

Social media and college student risk behaviors: A mini-review

Use of social media use is widespread and frequent among college students. Posting photos and text related to risk behaviors (e.g., problematic alcohol use, illicit drug use) on social media websites is common and has been linked to personal substance use and negative outcomes. This mini-review summarizes current findings related to associations between college students' social media use and engagement in risk behaviors. Conducting research on social media poses unique challenges for researchers; these challenges are reviewed and their impact on the state of the current literature discussed. Finally, implications for prevention and intervention efforts are discussed as well as recommendations regarding future research in the area of social media and college student risk behaviors.

How social media influence college students' smoking attitudes and intentions

Building on the influence of presumed influence (IPI) model, this study examines how smoking- related messages on social media influence college students' smoking. We surveyed 366 college students from three U.S. Midwestern universities in 2012 and examined the effects of expression and reception of smoking-related messages on smoking using path analysis. We found that the expression and reception of prosmoking messages not only directly affected smoking but also had indirect effects on smoking through (1) perceived peer expression of prosmoking messages and (2) perceived peer smoking norms. For antismoking messages, only reception had a significant indirect influence on smoking through (1) perceived peer reception of antismoking messages and (2) perceived peer smoking norms. In conclusion, social media function as an effective communication channel for generating, sharing, receiving, and commenting on smoking-related content and are thus influential on college students' smoking.

The Influence of Social Media on Addictive Behaviors in College Students

Social media has become a primary way for college students to communicate aspects of their daily lives to those within their social network. Such communications often include substance use displays (e.g., selfies of college students drinking). Furthermore, students' substance use displays have been found to robustly predict not only the posters' substance use-related outcomes (e.g., consumption, problems) but also that of their social networking peers.

PURPOSE OF REVIEW

The current review summarizes findings of recent literature exploring the intersection between social media and substance use.

RECENT FINDINGS

Specifically, we examine how and why such substance use displays might shape college students' internalized norms surrounding substance use and how it impacts their substance use-related behaviors.

SUMMARY

Additional social media-related interventions are needed in order to target reduction of consumption among this at-risk group. We discuss the technological and methodological challenges inherent to conducting research and devising interventions in this domain.

College Students' Drinking and Posting About Alcohol: Forwarding a Model of Motivations, Behaviors, and Consequences

College drinking continues to remain a public health problem that has been exacerbated by alcohol-related posts on social networking sites (SNSs). Although existing research has linked alcohol consumption, alcohol posts, and adverse consequences to one another, comprehensive explanations for these associations have been largely unexplored. Thus, we reasoned that students' personal motivations (i.e., espousing an alcohol identity, needing entertainment, and adhering to social norms) influence their behaviors (i.e., alcohol consumption and alcohol-related posting on SNSs), which can lead to alcohol problems. Using structural equation modeling, we analyzed data from 364 undergraduate students and found general support for our model. In particular, espousing an alcohol identity predicted alcohol consumption and alcohol-related SNS posting, needing entertainment predicted alcohol consumption but not alcohol-related SNS posting, and adhering to social norms predicted alcohol-related SNS posting but not alcohol consumption. In turn, alcohol consumption and alcohol-related SNS posting predicted alcohol problems. It is surprising that alcohol-related SNS posting was a stronger predictor of alcohol problems than alcohol consumption. We discuss the findings within their applied applications for college student health.

Evaluating College Students' Displayed Alcohol References on Facebook and Twitter

PURPOSE

Current trends suggest that adolescents and young adults typically maintain a social media "portfolio" of several sites including Facebook and Twitter, but little is known regarding how an individual chooses to display risk behaviors across these different sites. The purpose of this study was to investigate college students' displayed alcohol references on both Facebook and Twitter.

METHODS

Among a larger sample of college students from two universities, we identified participants who maintained both Facebook and Twitter profiles. Data collection included evaluation of 5 months of participants' Facebook and Twitter posts for alcohol references, number of social connections (i.e., friends or followers), and number of posts. Phone interviews assessed participants' frequency of Facebook and Twitter use and self-reported alcohol use. Analyses included Fisher's exact test, Wilcoxon matched pair sign test, Friedman rank-sum tests, and logistic regression.

RESULTS

Of 112 eligible participants, 94 completed the study. Participants were more likely to display alcohol references on Facebook compared with those on Twitter (76% vs. 34%, p = .02). Participants reported more social connections on Facebook versus Twitter (average 801.2 friends vs. 189.4 followers, p < .001) and were more likely to report daily use of Facebook versus Twitter (94.6% vs. 50%, p < .001). Current alcohol use was predictive of both Facebook and Twitter displayed alcohol references, but mediators differed in each model.

CONCLUSIONS

College students were more likely to display alcohol references on Facebook compared with those on Twitter. Understanding these patterns and predictors may inform prevention and intervention efforts directed at particular social media sites.

Underage college students' alcohol displays on Facebook and real-time alcohol behaviors

PURPOSE

College is often a time of alcohol use initiation and displayed Facebook alcohol references. The purpose of this longitudinal study was to determine associations between initial references to alcohol on social media and college students' self-reported recent drinking, binge drinking, and excessive drinking.

METHODS

First-year students from two U.S. public universities were randomly selected from registrar lists for recruitment. Data collection included 2 years of monthly Facebook evaluation. When an initial displayed Facebook alcohol reference was identified, these "New Alcohol Displayers" were contacted for phone interviews. Phone interviews used the validated timeline followback method to evaluate recent alcohol use, binge episodes, and excessive drinking. Analyses included calculation of positive predictive value and Poisson regression.

RESULTS

A total of 338 participants were enrolled; 56.1% participants were female, 74.8% were Caucasian, and 58.8% were from the Midwestern University. A total of 167 (49.4%) participants became new alcohol displayers during the first 2 years of college. Among new alcohol displayers, 78.5% reported past 28-day alcohol use. Among new alcohol displayers who reported recent alcohol use, 84.9% reported at least one binge episode. Posting an initial Facebook alcohol reference as a profile picture or cover photo was positively associated with excessive drinking (risk ratio = 2.34; 95% confidence interval, 1.54-3.58).

CONCLUSIONS

Findings suggest positive associations between references to alcohol on social media and self-reported recent alcohol use. Location of initial reference as a profile picture or cover photo was associated with problematic drinking and may suggest that a student would benefit from clinical investigation or resources.