E-cigarette and Cannabis in Social Media Influencer Marketing and Its Effect on Adolescents: A Survey-Based Experiment

Abstract

INTRODUCTION: Micro-influencers (1,000-100,000 followers) promote e-cigarettes alongside cannabis on social media. This study examined the effect of such marketing on adolescent perceptions of e-cigarettes and micro-influencers. METHODS: In this 2023-2024 survey-based, in-class repeated-measures experiment, California adolescent e-cigarette and cannabis never-users (N = 1,402; Mage = 17 [SD = 0.6]; 51.4% female, 41.7% Hispanic) were randomly shown three pairs of Instagram images featuring micro-influencers promoting: (1) e-cigarettes with cannabis (experimental group), (2) e-cigarettes alone (control), or (3) no substances (placebo). After viewing each image pair, participants rated perceived influencer credibility. After viewing all images, susceptibility to use e-cigarettes was assessed. Three susceptibility sub-items and their composite measure were compared across groups (experimental versus control; placebo versus control) and between participants who perceived micro-influencers as credible versus non-credible, using binomial generalized linear mixed effects models. The association of self-reported exposure to micro-influencer e-cigarette or cannabis posts with these outcomes was also assessed. RESULTS: Participants in the experimental group had higher odds of e-cigarette use intentions if offered by a friend among all and among those who perceived micro-influencers as credible, compared to controls. Those who self-reported exposure to micro-influencer e-cigarette or cannabis posts were at higher odds of overall susceptibility, intentions to use if a friend offers, and curiosity about e-cigarette use. CONCLUSIONS: Influencer e-cigarette promotion alongside cannabis, and perceptions of influencers as credible, may contribute to e-cigarette use intentions among adolescent never-users. Improvement of social media community guidelines and greater policy attention to e-cigarette and cannabis marketing are needed.