Social Media Fuels Smoking and Vaping Among Children, Especially Girls, Study Shows

The risks climbed steadily with each additional hour spent on social platforms — a pattern that persisted even after researchers accounted for family background and whether teens lived in homes where smoking or vaping occurred.

In other words, the more time teens spent on social media, the higher their risk of using cigarettes or e-cigarettes — and potentially developing serious health problems, from respiratory issues and premature heart damage to harmful impacts on their developing brains.

“The earlier you start smoking, the harder it is to quit, and the more likely you are to get diseases,” said Stanton Glantz, a retired professor of medicine and founding director of the UCSF Center for Tobacco Control Research and Education.

Associations in children were stronger than those previously reported in adults. The researchers say it remains unclear whether the correlation reflects targeted youth marketing by tobacco companies or greater susceptibility among younger users.

Evidence has shown that tobacco companies aggressively use social media, which itself has addictive elements. For instance, researchers reported last year that tobacco giant Philip Morris International systematically promotes its leading heated tobacco product worldwide through social media, leveraging digital platforms to advertise, engage users, and normalize product use.

“Increased exposure to advertising and promotion very likely explains part of this association,”  wrote lead author Dr. Anthony Laverty, an associate professor in public health at Imperial College London. The research team included Prof. Martin McKee, a leading expert on health and health care in Europe. “Vaping and tobacco content are widespread on social media and they are more likely to be portrayed positively than not.”

Published in the journal Tobacco Induced Diseases, the study lands amid growing concern that digital advertising and promotion by the tobacco industry and “ciginfluencers” are driving youth smoking. Its release also coincides with an under-16 ban on social media that took effect this week in Australia, aimed at protecting children from potential physical and mental health harms.

Key findings of the study include:

• Heavy social media use of seven or more hours a day was associated with more than five times the odds of cigarette smokingand about four times the odds of e-cigarette use, compared with teens who did not use social media.
• Even social media use of less than one hour a day was linked to nearly double the odds of smoking and vaping.
• Girls showed stronger associations than boys at every level of social media use: Heavy female users (seven or more hours) had nearly six times the odds of smoking, compared with about five times for males.For vaping, the gap was even wider. They had more than seven times the odds of e-cigarette use, versus about four times for boys.

In November, the head of the World Health Organization (WHO) called for tougher restrictions on nicotine products aimed at children, warning that tobacco dependence most often begins in childhood. Previous studies have linked social media use to smoking and vaping, including:

• A 2022 systematic review and meta-analysis of 29 studies with mostly adolescent participants showed that those exposed to tobacco content on social media, compared to those not exposed, had greater odds of reporting lifetime tobacco use, past 30-day tobacco use, and susceptibility to use tobacco among never users.
• A study published last year, using data up to 2017, found that social media use at the age of 14 years was linked to later e-cigarette use.
• Another systematic review, also published last year, reported that youth with no prior tobacco use who used social media daily were 67 percent more likely to begin smoking after one year.

The new research was conducted in the United Kingdom, which has high levels of e-cigarette and social media use despite a restrictive tobacco control environment. Tobacco products cannot legally be sold to people under age 18 in the U.K., compared to a federal minimum age of 21 in the U.S.

Researchers analyzed self-reported data from the United Kingdom Household Longitudinal Study, following nearly 9,400 adolescents aged 10–17 years between 2015-2016 through 2022-2023. About 5% of participants said they currently smoked cigarettes, and about 3% reported e-cigarette use.

Study limitations included a lack of data about specific social media platforms or content viewed and the inability to account for peer influence, mental health factors, or smoking and vaping by siblings. Still, the findings underscore the need to make social media a safer environment for young users, the authors conclude.

“This study adds to evidence that social media may be an important determinant of health,” they wrote. “Regulatory action and other steps to implement the WHO Framework Convention on Tobacco Control measures that prevent tobacco industry advertising, promotion and sponsorship (TAPS) via social media, are crucial.”

Reference

Laverty AA, Parnham JC, McKee M, Filippidis FT, Hopkinson NS. Social media use and child cigarette smoking and e-cigarette use: A cohort study 2015–2023. Tobacco Induced Diseases. 2025;23(November):1-6. doi:10.18332/tid/211432

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