Youth Perceptions of E-Cigarette Influencer Marketing on Social Media

INTRODUCTION: Youth exposure to e-cigarette-related influencer marketing on social media is associated with lower harm perceptions and greater susceptibility to e-cigarette use. Yet, youth perceptions of different types of influencer marketing remain underexplored. This study examined youth perceptions of explicit and implicit promotion and casual depiction of e-cigarettes by influencers, using focus groups to capture in-depth insights. METHODS: In 2023, we conducted six online focus groups with 23 California 12th graders (age 18; 65% female; e-cigarette never- and ever-users). Participants viewed Instagram, TikTok, and YouTube posts in which influencers either promoted e-cigarettes explicitly (displaying brand names), promoted e-cigarettes implicitly (without brand names), or depicted e-cigarettes casually without promotional cues. The semi-structured guide covered content appeal, influencer relatability, recognition of promotion, and e-cigarette perceptions. Thematic analysis was used to identify themes from transcripts. RESULTS: Participants found the following content appealing: casual e-cigarette displays perceived as non-promotional, and promotional videos with high production quality and trendy sounds. However, these perceptions did not translate into intentions to use e-cigarettes. Influencers casually displaying e-cigarettes were seen as more relatable than promoters, though some participants still saw them as problematic for normalizing vaping. Explicit promoters were perceived as financially motivated, while implicit promoters were perceived as potentially addicted, making both less relatable. CONCLUSIONS: Casual e-cigarette displays and engaging audiovisual effects elicited positive reactions but did not drive intentions to use e-cigarettes. Perceptions of addiction and normalization may have countered these positive perceptions. The findings highlight the need for continued youth education about e-cigarette health risks and marketing influence.