Study Finds Social Media Exposure Associated with Adolescent Cannabis, E-Cigarette Use

Exposure to social media content related to e-cigarettes and cannabis was associated with increased use of either, or both, products among adolescent patients, according to a study published in JAMA Network Open.¹ To prevent further substance use among younger patients, researchers suggest improvement of social media guidelines as well as the policies regarding marketing for e-cigarettes and cannabis.

“Nicotine e-cigarettes (hereafter, e-cigarettes) and cannabis products are among the most commonly used substances by adolescents in the US,” the authors of the study wrote. “In 2024, 3.5% of middle school and 7.8% of high school students reported current (past-month) e-cigarette use, whereas 8.3% of 8th graders and 29% of 12th graders reported using cannabis in the past year, 2023.”

Indeed, the dual use of cannabis and e-cigarettes has been rising at an alarming rate among American youth. Aside from the aforementioned statistics, at least 1.63 million high school and middle school students are currently using e-cigarettes. Of these students, 87.6% use flavored e-cigarettes and 26.3% use them every single day.²

Researchers conducted separate surveys to understand how social media content led to cannabis or e-cigarette use. | image credit: Fabio / stock.adobe.com

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On the other hand, reports on cannabis use in adolescent patients has shown opposite trends. According to Florida Atlantic University, adolescent cannabis use decreased from 23.1% to 15.8% from 2011 to 2021.³ While these statistics on cannabis use spanned 88,183 surveyed individuals, recent trends in social media use and the uncaptured cannabis use trends since 2021 may reveal varied evidence.

The Pew Research Center provided statistics regarding social media use among adolescents, showing that 35% of individuals 13 to 17 use one of the top social media applications “almost constantly.”⁴ Previous evidence has shown that e-cigarette and cannabis content on social media was associated with increased use of each product among adolescents.¹

To expand upon the evidence of social media, cannabis, and e-cigarette use in this population, researchers conducted 2 separate surveys for high school students in California.

“We conducted 2 studies among California adolescents to examine associations of exposure to e-cigarette and cannabis social media content with use of e-cigarettes, cannabis, or both,” the authors continued.¹ “On the basis of prior research, we hypothesized that exposure to posts from friends, microinfluencers or celebrities, but not from brands or unknown sources, would be associated with past-month e-cigarette, cannabis, or dual use.”

They conducted a longitudinal survey for baseline statistics in 2021 and 2022. Then, in the fall of 2023, researchers conducted a cross-sectional survey among the same population. The first study focused on overall exposure to e-cigarette and/or cannabis social media content, while the second study was geared toward content from specific sources such as friends, celebrities, microinfluencers, e-cigarette and/or cannabis brands, or unknown sources.

For the primary outcomes in each study, the longitudinal survey sought e-cigarette, cannabis, or dual use initiation at 1-year follow-up among baseline never-users of e-cigarettes and cannabis. For the second study, they uncovered the past-month use of either product, or past-month use of both.

“The studies found that although baseline frequent exposure to e-cigarette content broadly on social media was not associated with subsequent e-cigarette or cannabis use initiation, frequent exposure to cannabis content was associated with solo e-cigarette use (inconsistently), solo cannabis use, and dual use initiation 1 year later,” they wrote.¹ “Frequent exposure to e-cigarette posts on TikTok and exposure to e-cigarette and/or cannabis social media posts from friends and microinfluencers were associated with cannabis and dual use initiation or past-month use.”

In their first study, researchers revealed that 22.9% of adolescents reported frequent exposure to e-cigarette content and 12% reported frequent cannabis content. At follow-up, exposure to cannabis content was associated with solo cannabis, solo e-cigarette, and dual uses among adolescents.

With both cannabis- and e-cigarette-related content leading to the use of either product, researchers confirmed their hypotheses. Despite some social media channels contributing to use more than others (eg, TikTok), as well as cannabis content contributing more to overall use of these products, results of the study were enough to inform the researchers’ suggestions. Those suggestions included deeper exploration of social media and general marketing policies to avoid the increased substance use among adolescents across the country.

“Future research should explore whether shifts in tobacco and cannabis policies (eg, state-level cannabis legalization or a tightened premarket application review process for e-cigarette product market entry), social media community guideline enforcement (eg, prompt detection and removal of influencer vaping posts, regardless of the substance depicted), and prevention programs contribute to these associations,” the authors concluded.¹ “Improving social media guidelines and regulation of substance-related marketing, especially influencer promotions of e-cigarettes and cannabis, may help limit adolescent exposure and mitigate public health risks associated with youth e-cigarette and cannabis use.”

READ MORE: Pediatrics Resource Center

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References

1. Vassey J, Cho J, Vogel EA, et al. E-cigarette and cannabis social media posts and adolescent substance use. JAMA Netw Open. 2025;8(6):e2517611. doi:10.1001/jamanetworkopen.2025.17611

2. E-cigarette use among youth. CDC. October 17, 2024. https://www.cdc.gov/tobacco/e-cigarettes/youth.html

3. Galoustian G. Dramatic drop in marijuana use among U.S. youth over a decade. Florida Atlantic University News Desk. October 28, 2024. https://www.fau.edu/newsdesk/articles/marijuana-use-teens-study

4. Vogels EA, Gelles-Watnick R, Massarat N. Teens, social media and technology 2022. Pew Research Center. August 10, 2022. https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/