Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Jun 8, 2023
Open Peer Review Period: Jun 8, 2023 - Aug 3, 2023
Date Accepted: Aug 27, 2024
(closed for review but you can still tweet)
Social Media Exposure and Other Correlates of Increased E-cigarette Use among Adolescents during Remote Schooling: A Cross-Sectional Study from California, USA
ABSTRACT
Background:
Some studies have shown increased adolescent e-cigarette use during COVID Shelter-in-Place orders. However, little is known about the role of e-cigarette-related digital content, behavioral and mental health factors, and social environment on the change in adolescent e-cigarette use during Shelter-in-Place and remote schooling.
Objective:
To evaluate associations of increased adolescent e-cigarette use during Shelter-in-Place and remote schooling with exposure to e-cigarette-related digital content and other correlates: stronger e-cigarette dependence, feeling lonely, inability to socialize, e-cigarette use to cope with Shelter-in-Place, and the number of family members aware of participants’ e-cigarette use.
Methods:
A cross-sectional survey between August 2020 and March 2021 included 85 California adolescents (mean age=16.7±1.2, 46% women, 44% Hispanic) who reported past 30-day use of e-cigarettes. Multivariable penalized logistic regressions determined associations adjusted for age, race/ethnicity, and mother’s education. The outcome of increased e-cigarette use was defined as more frequent use of e-cigarettes of same or stronger nicotine or tetrahydrocannabinol concentration.
Results:
Almost all respondents (83/85, 98%) reported using social media more since Shelter-in-Place, and 74% (63/85) reported seeing e-cigarette digital content. More than half (46/85, 54%) reported increased e-cigarette use during Shelter-in-Place. Most who increased use were exposed to e-cigarette digital content (38/46, 83%) compared to those who did not increase e-cigarette use (25/39, 64%); but the association was nonsignificant after adjusting for demographics (Adjusted OR: AOR 2.34, 95% CI 0.71-8.46). Respondents who felt lonely (AOR 3.33, 95% CI 1.27-9.42), used e-cigarettes to cope with Shelter-in-Place (AOR 4.06, 95% CI 1.39-13.41), or had ≥2 family members aware of participants’ e-cigarette use (AOR 2.29, 95% CI 1.24-4.90) were more likely to report increased e-cigarette use.
Conclusions:
Almost all participants reported using social media more during Shelter-in-Place, with many respondents reporting increased e-cigarette use, and significant associations with loneliness and use to cope with Shelter-in-Place. Future e-cigarette use interventions should consider digital platforms and address the mental health consequences of the COVID-19 pandemic. Clinical Trial: N/A
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