BACKGROUND: Social media (SM) serves as a powerful vector in shaping behaviors and perceptions related to e-cigarette use. However, SM often bypasses tobacco control regulations, enabling tobacco companies to target youth through campaigns, influencer partnerships, and innovative strategies. This study examines the role of SM marketing exposure, individual factors, and peer and family influence on susceptibility to e-cigarette use among Indonesian youth. Susceptibility refers to the intention or openness to try e-cigarettes, an important precursor to initiation, making it a critical focus for prevention efforts.
METHODS: An online, cross-sectional survey was conducted from March to August 2023, involving Indonesian youth aged 15–24 from three provinces with the highest vaping prevalence (N=1,600; 37% male). The analytic sample consisted of 1,010 non-experimenters. Path analysis assessed proximal factors (exposure to e-cigarette ads on SM, peers’ e-cigarette use) and distal factors (sex, age, school characteristics, sensation-seeking, siblings’ e-cigarette use) influencing susceptibility to e-cigarette use among non-experimenters. Proximal variables were tested as mediators.
RESULTS: Age, male sex, a higher number of friends using e-cigarettes, public school enrollment, and higher sensation-seeking scores significantly predicted susceptibility to e-cigarette use. Conversely, exposure to SM advertisements and siblings’ e-cigarette use were not associated with susceptibility. Path analysis showed that peers’ e-cigarette use mediated the effects of higher sensation-seeking, male sex, and older age on susceptibility, while exposure to SM advertisements did not.
CONCLUSIONS: This study found that exposure to e-cigarette advertisements on SM did not predict susceptibility among non-experimenters. Further research is needed to determine whether SM ads drive initiation or primarily sustain e-cigarette use among Indonesian youth. Culturally relevant tobacco control interventions should focus on mitigating peer influence and regulating digital tobacco marketing.