Using social media for addressing vaping among young people in the Pacific Small Island Developing States: a systematic review

Main Article Content

Mayor Pokino
Professor Judith McCool
Dr Rosie Dobson
Lucy Hardie
Dr Sandra Hanchard

Keywords

social media, vaping, youth, Pacific Small Island Developing States, campaign

Abstract

Background: Vaping is now the most common form of nicotine use among young people, despite potential harms. The Western Pacific region (WPR) has one of the highest numbers of young vapers among the World Health Organization (WHO) regions. This is concerning as the Pacific Small Island Developing States (PSIDS) within the WPR are home to some of the most vulnerable nations in the world. Social media has been demonstrated by previous research as an effective medium for influencing the knowledge, attitudes and behaviour of young people about the harms associated with vaping. However, these studies have been conducted in high-income countries, and to our knowledge, no social media interventions addressing vaping among young people have been tested within the PSIDS. Therefore, this review aims to explore the effectiveness of using social media for addressing vaping among young people, identify features associated with success and consider the applicability of this study to the PSID region.


Methods: We searched Google Scholar, Scopus and PubMed (2010-2024) for articles, including assessing selected articles’ references. We included studies that used social media as intervention platforms for the harms of vaping and provided knowledge, attitudes and behavioural outcomes after the intervention.


Findings/Outcomes measure: Twenty-seven original studies showed that both social media–only interventions and integrated multi-component programmes involving social media led to shifts in knowledge, attitudes, and behaviours among young people aged 10–24 regarding the harms of vaping. However, the applicability of this finding to the PSIDS remains unclear. This review identified several considerations that must be addressed before adapting such interventions to the PSID region. Key among these is the adequacy of telecommunication networks, the strength of support infrastructure within these nations, and the digital skills required to engage effectively with social media–based programmes.


Conclusions: This review highlighted a range of studies demonstrating the effectiveness of social media-based vaping interventions. Given the widespread use of social media and its relatively low implementation costs, it may serve as an important vehicle for risk communication to reduce the burdens of preventable nicotine-related illness within the PSIDS.

Abstract 190 | PDF 179 Pokino v2 Downloads 9

References

1. World Health Organization. Tobacco. June 25, 2025. Accessed April 20th, 2024, from. https://www.who.int/news-room/fact-sheets/detail/tobacco.
2. Sathish T, Teo KK, Britz-McKibbin P, et al. Variations in risks from smoking between high-income, middle-income, and low-income countries: an analysis of data from 179 000 participants from 63 countries. Lancet Glob Health. 2022 Feb;10(2):e216-e226. doi: 10.1016/S2214-109X(21)00509-X
3. World Health Organization. Tobacco. Accessed March 3rd, 2024, from https://www.who.int/westernpacific/health-topics/tobacco#tab=tab_2.
4. World Health Organizaton. Tobacco use declines despite tobacco industry efforts to jeopardize progress. January 16, 2024. Accessed March 18th, 2024, from https://www.who.int/news/item/16-01-2024-tobacco-use-declines-despite-tobacco-industry-efforts-to-jeopardize-progress.
5. Zhang L, Harris Ao S, Francis Ye J, Zhao X. How does health communication on social media influence e-cigarette perception and use? A trend analysis from 2017 to 2020. Addict Behav. 2024 Feb;149:107875. doi: 10.1016/j.addbeh.2023.107875
6. Jerzyński T, Stimson GV, Shapiro H, Król G. Estimation of the global number of e-cigarette users in 2020. Harm Reduct J. 2021 Oct 23;18(1):109. doi: 10.1186/s12954-021-00556-7
7. Jerzynski T, Stimson GV. Estimation of the global number of vapers: 82 million worldwide in 2021. Drugs, Habits and Social Policy. 2023;24(2):91-103
8. Sun J, Xi B, Ma C, et al. Prevalence of E-Cigarette Use and Its Associated Factors Among Youths Aged 12 to 16 Years in 68 Countries and Territories: Global Youth Tobacco Survey, 2012‒2019. Am J Public Health. 2022 Apr;112(4):650-661. doi: 10.2105/AJPH.2021.306686
9. Jones K, Salzman GA. The Vaping Epidemic in Adolescents. Mo Med. 2020 Jan-Feb;117(1):56-58
10. Hair EC, JMK, ST, McKay T, DV. Reducing e-cigarette use among youth and young adults: evidence of the truth campaign’s impact. Tobacco Control. 2023;0:1-6
11. Villanti AC, Wackowski OA, LePine SE, et al. Effects of Vaping Prevention Messages on Electronic Vapor Product Beliefs, Perceived Harms, and Behavioral Intentions among Young Adults: A Randomised Controlled Trial. Int J Environ Res Public Health. 2022 Oct 30;19(21):14182. doi: 10.3390/ijerph192114182
12. Doumi R, Khaytan S, Alobaidan AS, et al. Knowledge, Attitude, and Practice of E-Cigarettes of Adolescents and Adults in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel). 2023 Nov 20;11(22):2998. doi: 10.3390/healthcare11222998
13. Rutherford BN, Sun T, Lim CCW, et al. Changes in Viewer Engagement and Accessibility of Popular Vaping Videos on TikTok: A 12-Month Prospective Study. Int J Environ Res Public Health. 2022 Jan 20;19(3):1141. doi: 10.3390/ijerph19031141
14. Liu J, Lee DN, Stevens EM. Characteristics Associated with Young Adults' Intentions to Engage with Anti-Vaping Instagram Posts. Int J Environ Res Public Health. 2023 Jun 5;20(11):6054. doi: 10.3390/ijerph20116054
15. Dai HD, Ratnapradipa K, Michaud TL, et al. Vaping Media Literacy, Harm Perception, and Susceptibility of E-Cigarette Use Among Youth. Am J Prev Med. 2022 Nov;63(5):852-860. doi: 10.1016/j.amepre.2022.05.012
16. Pokhrel P, Fagan P, Herzog TA, et al. Social media e-cigarette exposure and e-cigarette expectancies and use among young adults. Addict Behav. 2018 Mar;78:51-58. doi: 10.1016/j.addbeh.2017.10.017
17. Pérez A, Spells CE, Bluestein MA, et al. The Longitudinal Impact of Seeing and Posting Tobacco-related Social Media on Tobacco Use Behaviors Among Youth (Aged 12-17): Findings From the 2014-2016 Population Assessment of Tobacco and Health (PATH) Study. Tob Use Insights. 2022 Mar 14;15:1179173X221087554. doi: 10.1177/1179173X221087554
18. Bottorff JL, Struik LL, Bissell LJ, et al. A social media approach to inform youth about breast cancer and smoking: an exploratory descriptive study. Collegian. 2014;21(2):159-68. doi: 10.1016/j.colegn.2014.04.002
19. Cho H, Li W, Shen L, Cannon J. Mechanisms of Social Media Effects on Attitudes Toward E-Cigarette Use: Motivations, Mediators, and Moderators in a National Survey of Adolescents. J Med Internet Res. 2019 Jun 27;21(6):e14303. doi: 10.2196/14303
20. Escoto A, Watkins SL, Welter T, Beecher S. Developing a targeted e-cigarette health communication campaign for college students. Addict Behav. 2021 Jun;117:106841. doi: 10.1016/j.addbeh.2021.106841
21. Luo T, Li MS, Williams D, et al. Using social media for smoking cessation interventions: a systematic review. Perspect Public Health. 2021 Jan;141(1):50-63. doi: 10.1177/1757913920906845
22. Hair EC, Kreslake JM, Rath JM, et al. Early evidence of the associations between an anti-e-cigarette mass media campaign and e-cigarette knowledge and attitudes: results from a cross-sectional study of youth and young adults. Tob Control. 2023 Mar;32(2):179-187. doi: 10.1136/tobaccocontrol-2020-056047
23. Kreslake JM, Aarvig K, Liu MS, et al. Pathways to Quitting E-cigarettes Among Youth and Young Adults: Evidence From the truth® Campaign. Am J Health Promot. 2024 Sep;38(7):930-937. doi: 10.1177/08901171231218492
24. Baskerville NB, Azagba S, Norman C, et al. Effect of a Digital Social Media Campaign on Young Adult Smoking Cessation. Nicotine Tob Res. 2016 Mar;18(3):351-60. doi: 10.1093/ntr/ntv119
25. McKelvey K, Ramo D. Conversation Within a Facebook Smoking Cessation Intervention Trial For Young Adults (Tobacco Status Project): Qualitative Analysis. JMIR Form Res. 2018 Sep 4;2(2):e11138. doi: 10.2196/11138
26. England KJ, Edwards AL, Paulson AC, et al. Rethink Vape: Development and evaluation of a risk communication campaign to prevent youth E-cigarette use. Addict Behav. 2021 Feb;113:106664. doi: 10.1016/j.addbeh.2020.106664
27. Kim M, Olson S, Jordan JW, Ling PM. Peer crowd-based targeting in E-cigarette advertisements: a qualitative study to inform counter-marketing. BMC Public Health. 2020 Jan 23;20(1):32. doi: 10.1186/s12889-019-8126-x
28. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71
29. Methley AM, Campbell S, Chew-Graham C, et al. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014 Nov 21;14:579. doi: 10.1186/s12913-014-0579-0
30. Lamberton C, Stephen AT. A Thematic Exploration of Digital, Social Media, and Mobile Marketing: Research Evolution from 2000 to 2015 and an Agenda for Future Inquiry. Journal of Marketing. 2016;80:6
31. Lazard AJ. Social Media Message Designs to Educate Adolescents About E-Cigarettes. J Adolesc Health. 2021 Jan;68(1):130-137. doi: 10.1016/j.jadohealth.2020.05.030
32. Alpert JM, Chena H, Adamsb K-A. E-cigarettes and social media: attitudes and perceptions of young adults to social media messages. Addiction Research and Theory. 2020;28(5):387 - 96
33. Getachew B, Payne JB, Vu M, et al. Perceptions of Alternative Tobacco Products, Anti-tobacco Media, and Tobacco Regulation among Young Adults: A Qualitative Study. Am J Health Behav. 2018 Jul 1;42(4):118-130. doi: 10.5993/AJHB.42.4.11
34. Kelder SH, Mantey DS, Dusen DV, Case K, Haas A, Springer AE. A Middle School Program to Prevent E-Cigarette Use: A Pilot Study of “CATCH My Breath”. Public Health Reports. 2020;135(2):220-9
35. MacMonegle AJ, Smith AA, Duke J, et al. Effects of a National Campaign on Youth Beliefs and Perceptions About Electronic Cigarettes and Smoking. Prev Chronic Dis. 2022 Apr 7;19:E16. doi: 10.5888/pcd19.210332
36. Meacham MC, Ramo DE, Prochaska JJ, et al. A Facebook intervention to address cigarette smoking and heavy episodic drinking: A pilot randomised controlled trial. J Subst Abuse Treat. 2021 Mar;122:108211. doi: 10.1016/j.jsat.2020.108211
37. Noar SM, Gottfredson NC, Kieu T, et al. Impact of Vaping Prevention Advertisements on US Adolescents: A Randomised Clinical Trial. JAMA Netw Open. 2022 Oct 3;5(10):e2236370. doi: 10.1001/jamanetworkopen.2022.36370
38. Popova L, Fairmana RT, Akania B, Dixonb K, Weavera SR. “Don't do vape, bro!” A qualitative study of youth’s and parents’ reactions to e-cigarette prevention advertisements. Addiction Behaviours. 2021;112
39. Stevens EM, Keller-Hamilton B, Mays D, et al. Optimizing Images for an E-Cigarette Messaging Campaign: Liking and Perceived Effectiveness. Int J Environ Res Public Health. 2021 Dec 9;18(24):12989. doi: 10.3390/ijerph182412989
40. Tattan-Birch H, Jackson SE, Ide C, et al. Evaluation of the Impact of a Regional Educational Advertising Campaign on Harm Perceptions of E-Cigarettes, Prevalence of E-Cigarette Use, and Quit Attempts Among Smokers. Nicotine Tob Res. 2020 Jun 12;22(7):1148-1154. doi: 10.1093/ntr/ntz236
41 Thrul J, Ramo DE. Cessation Strategies Young Adult Smokers Use After Participating in a Facebook Intervention. Subst Use Misuse. 2017 Jan 28;52(2):259-264. doi: 10.1080/10826084.2016.1223690
42. Trigg J, Ela O, Bowden J, et al. Vaping harms awareness messaging: exploring young South Australians' responses to vaping prevention campaign materials. Health Promot Int. 2023 Dec 1;38(6):daad145. doi: 10.1093/heapro/daad145
43. Vereen RN, Krajewski TJ, Wu EY, et al. Aided recall of The Real Cost e-cigarette prevention advertisements among a nationally representative sample of adolescents. Prev Med Rep. 2022 Jun 17;28:101864. doi: 10.1016/j.pmedr.2022.101864
44. Villanti AC, LePine SE, West JC, et al. Identifying message content to reduce vaping: Results from online message testing trials in young adult tobacco users. Addict Behav. 2021 Apr;115:106778. doi: 10.1016/j.addbeh.2020.106778
45. Vogel EA, Unger JB, Vassey J, Barrington-Trimis JL. Effects of a nicotine warning label and vaping cessation resources on young adults' perceptions of pro-vaping Instagram influencer posts. Addict Behav. 2024 Feb;149:107888. doi: 10.1016/j.addbeh.2023.107888
46. Chen X, Yu B, Wang Y. Initiation of Electronic Cigarette Use by Age Among Youth in the U.S. Am J Prev Med. 2017 Sep;53(3):396-399. doi: 10.1016/j.amepre.2017.02.011
47. Movsisyan A, Arnold L, Evans R, et al. Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance. Implement Sci. 2019 Dec 17;14(1):105. doi: 10.1186/s13012-019-0956-5
48. Research GFFH. The 10/90 report on health research 2000. Geneva: Global Forum for Health Research, 2000. 7. Gulland A. Plan to stimulate research in developing countries is put on hold. BMJ Open. 2000;2012(344)
49. Villanti AC, Johnson AL, Ilakkuvan V, et al. Social Media Use and Access to Digital Technology in US Young Adults in 2016. J Med Internet Res. 2017 Jun 7;19(6):e196. doi: 10.2196/jmir.7303
50. Global System for Mobile Communication Association. (2019). The Mobile Economy: Pacific Islands. Retrieved from London, England:
51. Khosla, V., & Pillay, P. (2020). COVID-19 in the South Pacific: science communication, Facebook and ‘coconut wireless’. JCOM, 5(19)
52. Stubbs T, White V, Yong H-H, Toumbourou JW. Implications of nicotine vaping products for tobacco control in ASEAN low-income and middle-income countries: in-depth interviews with experts from the region. BMJ Open. 2023;13
53. United Nations Children’s Fund. (2024). Digital Transformation in the East Asia and Pacific region. Accessed March 18th, 2025, from https://www.unicef.org/eap/media/16181/file/Final%20DX%20Annual%20Report%20web.pdf.pdf

Similar Articles

1-10 of 111

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)