Smith M J, Hilton S. Adolescents' views on user-generated content and influencer marketing of e-cigarettes on social media: a focus group study. Lancet 2022; 400 Suppl 1: S77.

Given the high level of pre-adolescents' and adolescents' engagement with social media, these findings provide worrying evidence that e-cigarettes are attractive to this population group.

Twenty focus groups were conducted in 2022, with 82 pre-adolescents and adolescents aged 11-16 years living in Scotland. Participants were asked about smoking and vaping behaviours, social media use, vaping advertisement exposure, and were shown illustrative examples of typical social media content, which were used to stimulate discussion. Participants mentioned seeing e-cigarette advertising mostly through social media platforms, such as Instagram and TikTok. Youths agreed that e-cigarettes portrayed on social media were often glamourised as being 'cool', enticing by social media influencers, and viewed as a modern lifestyle accessory. Participants typically viewed e-cigarettes as less harmful than traditional cigarettes, but also expressed concerns about the scarcity of health and age warnings on social media. Participants stated that the adverts were branded to target their age group and that the e-cigarette flavourings encouraged youths to want to try the products. The authors suggest the need for policies to restrict the marketing of e-cigarettes on social media.