Association Between Exposure to Tobacco Content on Social Media and Tobacco Use: A Systematic Review
Thursday, September 15, 2022
Posted by: Natalia Gromov
Donaldson
SI, Dormanesh A, Perez C, Majmundar A, Allem JP.
Association Between
Exposure to Tobacco Content on Social Media and Tobacco Use: A Systematic
Review and Meta-analysis.
JAMA Pediatr. 2022;176(9):878-885. doi:10.1001/jamapediatrics.2022.2223
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.
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