Agus Susanto, Dody Mulyanto, Rizka Licia

THE IMPACT OF SOCIAL MEDIA AND KNOWLEDGE ON ADOLESCENTS' INTENTIONS TO ENGAGE IN E-CIGARETTE SMOKING

Introduction

The impact of social media and knowledge on adolescents' intentions to engage in e-cigarette smoking. Social media exposure fuels adolescents' e-cigarette intent; knowledge reduces it. Prevent e-cigarette use by cutting content exposure and boosting awareness of health risks.

Abstract

Introduction: The global prevalence of e-cigarette use among adolescents (11.3%) is increasing, primarily driven by exposure to promotional content on social media platforms. Aims: This study aimed to examine how exposure to e-cigarette content, content type, e-cigarette-related activity within the content, and knowledge about e-cigarettes influence adolescents’ intention to use e-cigarettes. Method: This survey-based study was conducted in Surakarta, Central Java, in November 2024. A total of 260 junior and senior high school students were selected through stratified random sampling. Data were collected using a structured questionnaire, and logistic regression analysis was applied to evaluate the relationships between variables. Results: The analysis indicated that exposure to e-cigarette content significantly increased the intention to use e-cigarettes (p < 0.001). In contrast, higher levels of knowledge about e-cigarettes were significantly associated with a lower intention to use them (p = 0.020). However, neither the type of content nor the presence of e-cigarette-related activity within the content showed a significant association with use intention (p = 0.501 and p = 0.162, respectively). The logistic regression model accounted for 25% to 34% of the variance in e-cigarette use intention, suggesting a moderate explanatory power. Conclusion: These findings underscore the significant influence of e-cigarette content exposure and adolescents’ knowledge levels on their intention to use e-cigarettes. While exposure increases the likelihood of use, adequate knowledge appears to reduce it. Therefore, reducing adolescents’ exposure to e-cigarette content and improving their awareness of the associated health risks may serve as effective strategies to prevent e-cigarette initiation.

Review

This study critically examines the complex interplay between social media exposure, knowledge, and adolescents' intentions to engage in e-cigarette use, a highly relevant public health issue given the rising global prevalence. Utilizing a survey-based approach with 260 junior and senior high school students in Surakarta, Central Java, the authors employed stratified random sampling and logistic regression to identify key predictors. The findings robustly demonstrate that exposure to e-cigarette content on social media significantly increases the intention to use, while, conversely, higher levels of knowledge about e-cigarettes significantly reduce this intention. Interestingly, neither the specific type of content nor the presence of e-cigarette-related activity within the content emerged as significant predictors, suggesting that mere exposure to promotional material is sufficient to influence intent. While the study addresses a crucial topic with a clear methodology and appropriate statistical analysis, several points warrant consideration. The most glaring issue is the stated study period: "November 2024." As this review is being conducted prior to that date, it strongly suggests a typographical error in the abstract, as the results are presented as having been already "indicated" and "accounted for." If this is not a typo, it raises fundamental questions about the empirical basis of the reported findings. Additionally, while stratified random sampling is a strength, the study's confinement to one city in Central Java limits the generalizability of the findings to broader adolescent populations. Further, the abstract could benefit from a brief description of how "exposure to e-cigarette content," "content type," "e-cigarette-related activity," and "knowledge" were operationalized and measured to enhance clarity and replicability. The moderate explanatory power (25-34% of variance) also indicates that other unmeasured factors play a significant role in shaping adolescents' intentions. Despite these methodological caveats, the study's conclusions offer valuable insights for public health initiatives. The dual finding that exposure increases intention while knowledge decreases it provides a clear strategic direction: interventions should focus both on reducing adolescents' exposure to e-cigarette content on social media and on enhancing their understanding of the associated health risks. Future research could build upon these findings by exploring the specific mechanisms through which social media content influences intent (e.g., perceived social norms, direct appeals), conducting longitudinal studies to track actual behavior, and investigating the effectiveness of educational programs designed to improve e-cigarette knowledge. Examining a wider range of social media platforms and cultural contexts would also strengthen the external validity of these important findings.

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