PROJECT SUMMARY
While digital marketing of tobacco products is becoming increasingly common, the role of social media
platforms in tobacco control is still understudied. An emerging body of research shows that social media
promotion of flavored tobacco products (i.e., electronic nicotine delivery systems (ENDS), cigars, cigarillos,
little cigars, hookah/waterpipe, pipe, smokeless tobacco, heat-not-burn products) is rapidly growing. These
messages are currently under-regulated, target youth, often contain misinformation, and feature branded
merchandise and celebrity or “influencer” promotion. Youth use social media at higher rates than the general
population in the U.S., which potentially multiplies the effect of targeted social media marketing. The existing
regulatory imbalances in treatment of flavored tobacco products (FTPs) and digital marketing of tobacco
products may explain recent trends in youth FTP use. In particular, the recent exponential rise in social media
advertising coincided with significant increases in ENDS and other FTP use among U.S. youth, which has
erased recent progress in reducing overall tobacco product use among youth. Understanding the impact of
exposure to social media content can inform tobacco regulatory science. Unfortunately, to date, no studies
have examined the impact of social media marketing of such FTPs. This project will fill this critical research
gap. The overarching goal of this project is to examine the effects of exposure to FTP-related social media
content and provide timely scientific basis for regulatory actions on restricting marketing of these products. The
specific aims of the proposed project are Aim 1: to identify and characterize potentially regulatable social
media message content related to FTPs by source (e.g., brand, influencer/community, regular consumer) and
major themes (e.g., new-user targeting, health risks, flavor-type); Aim 2: to examine the impact of exposure to
commercial and influencer FTP content on product sales and on youth and young adult awareness, risk
perceptions, intentions to use, initiation, and patterns of use of FTP products; and Aim 3: to study whether/to
what extent FTP regulatory policies modify the impact of exposure to social media content on FTP product
sales and youth and young adult awareness, risk perceptions, intentions to use, initiation, and patterns of use
of FTP products. These aims will be accomplished by applying classic theories of health behavior and
advertising, along with innovative analytic methods, to a unique combination of data sets, including social
media data from Twitter and Instagram, individual-level data on exposure to tobacco marketing, tobacco
attitudes, and tobacco use from the Population Assessment of Tobacco and Health (PATH) surveys, FTP sales
volume data from Nielsen store scanner data, and state/local FTP policy data collected by NORC. The findings
from this project will (a) inform regulatory science by highlighting potential regulatory actions for flavored
tobacco products and for social media, b) contribute to health communication theory, and c) be translatable to
other health behavior research.
