Adolescent E-cigarette use, social media exposure and socioeconomic inequality – results from a german school-based survey

TL;DR

This study finds that adolescent e-cigarette use in Germany is linked to social media exposure, higher pocket money, and parental nicotine use, with age being a stronger predictor than gender.

Contribution

The study identifies specific socioeconomic and digital factors influencing adolescent e-cigarette use in Germany and highlights gaps in prevention strategies.

Findings

37.2% of adolescents had tried e-cigarettes, with use increasing with age.

Exposure to e-cigarette content on TikTok and Instagram significantly increased e-cigarette use.

Only 41% of students reported receiving school-based education on e-cigarette use.

Abstract

Adolescent e-cigarette use has increased worldwide, reflecting digital exposure and shifting norms. This study aimed to identify socioeconomic and digital determinants of e-cigarette use among adolescents and to inform prevention strategies.

Data were collected from April to July 2024 among 829 students aged 11 to 19 years in three schools in northern Germany. An age-adapted questionnaire co-developed with students assessed sociodemographic characteristics, parental and media influences, risk perception, and nicotine use. Descriptive statistics and logistic regression models were applied.

Of all participants, 37.2% had tried e-cigarettes and 6.7% reported daily use. E-cigarette use increased with age (p < .01) but did not differ by gender. Exposure to e-cigarette content on TikTok (OR = 3.32, p < .01) and Instagram (OR = 3.00, p < .01) showed associations with e-cigarette use. Higher pocket money and parental nicotine consumption were associated with increased odds of e-cigarette use (OR = 3.00, p < .01; OR = 4.05, p < .01). Only 41% reported receiving school-based education on e-cigarette use.

Adolescent e-cigarette use is shaped by digital exposure, socioeconomic resources, and parental behavior. Prevention requires regulation of advertising, integration into school curricula, and family-based communication.

•Nearly half of adolescents tried e-cigarettes; age, not gender, predicts use.•About half of older teens saw nicotine content on TikTok/Instagram.•Parental nicotine use and higher pocket money raise risk; reading and education protect.•Only 41% report school discussion of vaping, revealing a major prevention gap.•Participatory surveys are feasible; policy should curb algorithmic vaping promotion.

Nearly half of adolescents tried e-cigarettes; age, not gender, predicts use.

About half of older teens saw nicotine content on TikTok/Instagram.

Parental nicotine use and higher pocket money raise risk; reading and education protect.

Only 41% report school discussion of vaping, revealing a major prevention gap.

Participatory surveys are feasible; policy should curb algorithmic vaping promotion.

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