Exposure to e-cigarette information and advertising in social media and e-cigarette use in Australia: a mixed methods study

Objectives: The aim of this study was to explore how e-cigarette users in Australia accessed e-cigarette information and advertising on social media platforms.

Methods: The mixed-methods study design included a survey and semi-structured interviews. Data were collected from March 2019 to July 2019 in Australia. Interviews were conducted following survey participation. Analysis of survey results examined associations between social media and advertising factors and use of e-cigarettes. Thematic analysis methods were applied to interview responses to explore e-cigarette information search and advertising exposure in different social media channels.

Results: The survey had 185 respondents and 14 participated in the interviews. The average social media use time was 11.4 h/week (SD ± 2.05). A total of 91 (49.2 %) participants sought out relevant information and 104 (56.2 %) were exposed to e-cigarette advertisements on social media platforms. Participants who searched for e-cigarette information on social media were more likely to report past (OR = 5.04; 95 % CI 2.23−11.42; p = 0.001) or current e-cigarette use (OR = 9.27; 95 % CI 4.22−20.34; p = 0.001), compared to participants who had never used e-cigarettes. The same relationship was observed for exposure to e-cigarette advertising. Thematic analysis of interviews revealed the diversity of sources of information for e-cigarettes, the pervasiveness of advertising, and the importance of peer recommendations.

Conclusions: Australian e-cigarette users seek or are exposed to e-cigarette information on a variety of social media platforms. Access to e-cigarette information was concentrated among e-cigarette users but peer influence may be a risk for uptake among non-smokers.