BACKGROUND: Research on the association between social media use and the use of electronic vaping is on the rise, particularly in developed countries. The emergence of oral nicotine pouches and other nicotine-containing products on the market, along with their growing popularity, highlights the need for further studies on the link between the use of nicotine products and exposure to social media, especially in low and middle income countries.
METHODS: Data were obtained from the Health Behaviour in School-Aged Children survey conducted in Serbia in 2022 on the sample 3962 adolescents aged 11, 13, and 15 years. Five multivariate logistic regression models were used to examine associations between intensive and problematic social media use and the lifetime use of cigarettes, e-cigarettes, water pipes, oral nicotine pouches, and heated tobacco products.
RESULTS: Data on lifetime prevalence reveal nicotine product use among Serbian youth aged 11, 13, and 15: cigarettes (15.1%), e-cigarettes (19.7%), waterpipes (7.1%), oral nicotine pouches (4.9%), and heated tobacco products (6.3%). Intensive social media use is reported by 51.6%, while 9.9% meet criteria for problematic use. Both intensive and problematic social media use were strongly associated with lifetime cigarette (p < 0.001) and e-cigarette use (p < 0.001), adjusting for age and sex. Waterpipe use was linked to intensive (p < 0.001) and problematic (p = 0.001) social media use. Oral nicotine pouch use showed associations with intensive (p = 0.006) and problematic use (p < 0.001). For heated tobacco products, only problematic social media use was significant (p < 0.001), with no link to intensive use (p = 0.402).
CONCLUSIONS: The results highlight the importance of identifying effective strategies to limit exposure to content promoting the use of nicotine-containing products and conducting both quantitative and qualitative studies to further investigate content that particularly appeals to youth.