Association Between Exposure to Tobacco Content on Social Media and Tobacco Use

A Systematic Review and Meta-analysis

Dados Bibliográficos

ID23338554
AutoresScott Donaldson (0000-0001-8145-0860, University of Southern California), Scott I Donaldson (0000-0002-8248-3514, University of Southern California), Allison Dormanesh (0000-0001-9060-7356, University of Southern California), Cindy Pérez (University of Southern California), Anuja Majmundar (0000-0002-7785-3357, American Cancer Society), Jon-Patrick Allem (0000-0001-9135-8689, University of Southern California)
Ano2022
Volume176
Fascículo9
Páginas878
Data de publicação2022-09-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJAMA Pediatrics (JOURNAL)
Identificadores do periódicoISSN: 2168-6203 • E-ISSN: 2168-6211
EditoraAmerican Medical Association (AMA) (PUBLISHER)
DOI10.1001/jamapediatrics.2022.2223
PMID35816331
OpenAlexW4285028826
IdiomaEN
Citações recebidas56
Referências citadas58

Importance: Exposure to tobacco-related content on social media may foster positive attitudes toward tobacco products and brands, and influence the likelihood of initiating or continuing use of tobacco, especially among adolescents and young adults. Objective: To perform the first systematic review and meta-analysis, to our knowledge, on studies that examined the association between exposure to tobacco content on social media and lifetime tobacco use, past 30-day tobacco use, and susceptibility to use tobacco among never users. Data Sources: Tobacco, social media, and marketing search terms were entered into online databases, including MEDLINE, ISI Web of Science, Scopus, and PsychINFO. Study characteristics, including research design and methods, sampling strategy, and demographics, were assessed for each study. Study Selection: Studies reporting odds ratios (ORs) for self-reported exposure to, or experimentally manipulated, tobacco content on social media and lifetime tobacco use, past 30-day tobacco, and susceptibility to use tobacco among never users. The systematic search produced 897 independent articles, of which 29 studies met inclusion criteria. Data Extraction and Synthesis: A 3-level random-effects meta-analysis was used to estimate ORs, 95% CIs, and heterogeneity (I2) for each tobacco use outcome. Study quality and publication bias were assessed. Main Outcomes and Measures: Lifetime tobacco use, past 30-day tobacco use, and susceptibility to use tobacco among never users. Tobacco use included e-cigarettes, cigarettes, and other (cigar, hookah, smokeless tobacco). Results: The total sample size across the 24 included datasets was 139 624, including 100 666 adolescents (72%), 20 710 young adults (15%), and 18 248 adults (13%). Participants who were exposed to tobacco content on social media, compared with those who were not exposed, had greater odds of reporting lifetime tobacco use (OR, 2.18; 95% CI, 1.54-3.08; I2 = 94%), past 30-day tobacco use (OR, 2.19; 95% CI, 1.79-2.67; I2 = 84%), and susceptibility to use tobacco among never users (OR, 2.08; 95% CI, 1.65-2.63; I2 = 73%). Subgroup analyses showed similar associations for tobacco promotions, active engagement, passive engagement, lifetime exposure to tobacco content, exposure to tobacco content on more than 2 platforms, and exposure to tobacco content among adolescents and young adults. Conclusions and Relevance: Findings suggest that a comprehensive strategy to reduce the amount of tobacco content on social media should be developed by federal regulators. Such actions may have downstream effects on adolescent and young adult exposure to protobacco content, and ultimately tobacco use behaviors.

Environmental health · Logistic regression · Meta-analysis · Odds · Odds ratio · Population · Smokeless tobacco · Social media · Tobacco use · World Wide Web · Health Literacy and Information Accessibility · Medicine · Smoking Behavior and Cessation · Social Media in Health Education