Use of traditional, combustible cigarettes has declined dramatically in recent years. But the popularity of electronic cigarettes – particularly among teens – concerns public health professionals around the world. How might social media - which easily transcends national borders – explain the popularity of e-cigarette use?
Tobacco policy and communications expert Jim Thrasher believes the decision goes well beyond the individual. In a new $2.8 million grant from the National Cancer Institute, the health promotion, education, and behavior professor will investigate how social influences – particularly those through social media – impact teens’ decisions to smoke and use e-cigarettes.
“In recent years, the popularity of e-cigarettes among teens and young adults has threatened to reverse the great progress we have made in reducing teen smoking, not only in the United States but around the world,” Thrasher says. “With this study, we’re investigating how teens' peer networks at school, including their best friends and others with whom they communicate online, influence them to both start and continue to smoke and use e-cigarettes.”
The project builds on a recently completed study where Thrasher collaborated with scientists in Mexico and Guatemala to better understand the use and public health impacts of e-cigarettes in those countries. Thrasher teamed up with co-primary investigator Joaquin Barnoya, who was recently named Minister of Health for Guatemala, to publish more than 50 peer-reviewed papers detailing the findings the study unearthed. Their research, as well as other studies, has found that teens’ exposure to e-cigarette ads and content through social media is associated with their use of e-cigarettes.
“Existing research on how peers influence tobacco product use is almost exclusively based on studies of best friend networks,” Thrasher says. “But emerging studies suggest the less intimate, yet highly ubiquitous connections teens make through online networks – like those that take place via social media – appear to play an increasingly important role in promoting unhealthy behaviors like tobacco use.”
Government efforts to regulate social media and online communications are important but often difficult to implement. By contrast, recent school-based interventions aimed at reducing teen bullying have been successful when leveraging and intervening through online, social media interaction networks.
With these developments in mind, Thrasher and co-investigator Diego Leal (a former associate professor of sociology at USC) will compare the influence of best friend networks vs online interaction networks on the initiation and progression of e-cigarette and cigarette use among Mexican high school students over a 2.5-year period. They will also assess the potential impacts of policies, like banning flavors, through experiments to assess their importance in teens’ decisions to use nicotine products. The USC research team includes biostatistics professor James Hardin, who will provide statistical expertise around the innovative experimental methods, as well as postdoctoral fellow Desiree Vidaña and doctoral student Liz Cruz, both of whom have led key research on social networks and e-cigarette use in Mexico that laid the foundation for this project.
By using statistical modeling, the team will create a virtual laboratory where they can evaluate the effectiveness of various interventions – whether network-based or policy-focused – to reduce teens’ use of nicotine products, including comparison of results with those based on U.S. high school students. Feedback from key stakeholders (e.g., students, school administrators, federal decision makers, advocates) will help further assess the feasibility and efficacy of different intervention strategies.