The Effects of Branded and Influencer Social Media Promotion of Flavored Tobacco Products (FTP) on FTP Use Among Youth and Young Adults

Innovative approaches to study the effects of social media flavored tobacco promotion & marketing on tobacco use among youth and young adults

While cigarette smoking has declined among youth and young adults, recent use of flavored tobacco products (FTPs) has increased sharply, especially of products like electronic nicotine delivery systems (ENDS), little cigars/cigarillos (LCCs) and hookah. Therefore, pairing increased use of FTPs with the largely non-existent regulation of tobacco marketing on social media, such as restrictions on youth-targeting, misleading health claims, and the use of celebrity spokespeople, we anticipate that social media marketing of FTPs is a major driver of increased use among youth and young adults. This three-year study (2021-2024), funded by the National Institutes of Health’s National Institute on Drug Abuse and the Federal Drug Administration’s Center For Tobacco Products, aims to better understand the relationship between social media marketing of FTPs and increased use among youth.

The specific aims of this study are as follows:

  1. Identify, geolocate, and characterize the sources and content of potentially-regulatable social media promotion of FTPs.
  2. Examine the impact of exposure to FTP social media promotion on FTP attitudes, beliefs, and use using two analytic strategies:
    1. Analyze the effects of FTP social media promotions on individual FTP-related attitudes, beliefs, and behaviors of youth and young adults;
    2. Analyze the effects of FTP social media promotions on FTP product sales.
  3. Examine whether and to what extent federal, state, and local FTP regulations modify the impact of exposure to FTP social media content on individual FTP-related attitudes, beliefs, and behaviors, and product sales.

This study leverages a unique combination of data sets: social media data from Twitter and Instagram, individual-level longitudinal behavioral data from the Population Assessment of Tobacco and Health (PATH) Surveys, FTP sales data from Nielsen store scanner data, and tobacco policy data from Tobacconomics and the CDC STATE system. Moreover, this project aims to fill gaps in research by characterizing FTP marketing messages on social media and assessing their impact on attitudes and tobacco use behavior among US youth and young adults, in the context of a highly dynamic regulatory environment and the evolving COVID-19 global pandemic.

The findings from this project will (a) inform regulatory science by highlighting potential regulatory actions for FTPs and for social media tobacco marketing, (b) contribute to health communication theory, and (c) be translatable to other health behavior research.


Shannon Watkins, PhD
Assistant Professor, University of Iowa

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