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expert reaction to observational study on smoking/vaping and social media use

A study published in Thorax looks at social media use and smoking and vaping in youths. 


Dr Graham Wheeler, Honorary Senior Lecturer at the Imperial Clinical Trials Unit, Imperial College London, and Statistics Director for Statistical Innovation in Specialty and Primary Care at GSK, said:

“The results of this large study are similar to the findings of other research into the association of social media use and smoking habits.

“However, the researchers didn’t record the social media platforms used, or how the users interacted with friends on these platforms. For example, are stronger associations seen amongst users of TikTok or Instagram compared to Whatsapp?

“Social media use is self-reported, so may not be an accurate record of actual use.

“The researchers also assessed how the interaction of social media use and variables such as age, household income and sex were associated with cigarette and e-cigarette use. However, they did not report the interaction of social media use with parental use of cigarettes and e-cigarettes, which is one of the strongest variables associated with children’s smoking habits. We don’t know if this trend of higher odds of being a smoker increasing with social media usage changes when comparing children of parents who are smokers and children of parents who are not smokers.”

“This survey reports responses given at a single point in time, rather than following non-smokers over time to see if the likelihood of them taking up cigarette smoking or e-cigarette use is associated with increasing levels of social media use”.

“Plenty of research has shown that if your peers are smokers, you are more likely to be a smoker. However this study did not account for the amount of overall social activity, both in time spent socialising and how large someone’s social network is. Adjusting for overall social activity may provide further insights into the actual effect of social media use on cigarette and e-cigarette use.”


Dr Amrit Kaur Purba, postdoctoral researcher at the Oxford Internet Institute, said:

“A significant contribution to the ongoing discussion, this recent study, analysing a nationally representative survey of UK youth sheds light on the potential link between social media use and young people’s engagement in cigarette, e-cigarette, and dual use. Specifically, the study suggests that as the time a young person spends on social media increases, their likelihood of cigarette, e-cigarette, and dual use of both products may also increase.

“To fully understand if this relationship is causal, there is a need for broader consideration of important characteristics such as risk taking, in-person activities and parenting styles, as well as other characteristics which may influence any reported relationships between social media use and youth cigarette, e-cigarette and dual use.

“The study additionally highlights a possible bidirectional relationship, suggesting that young people who engage in smoking or vaping might be more drawn to social media platforms.

“Future research endeavours should meticulously and transparently address these complexities and prioritise securing more accurate objective social media measures to unravel the true nature of any potential causal relationship between specific aspects of social media use, such as exposure to nicotine-related products, and youth cigarette, e-cigarette, and dual use.”



‘Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study’ by Nicholas Hopkinson et al. was published in Thorax at 23:30 UK time Thursday 16 May 2024.





Declared interests

Amrit Purba: I recently published an article investigating the same issue which documented similar findings but was more focused on identifying the potential causal relationship between time spent on social media use and adolescent cigarette, e-cigarette and dual use (

No support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.  Funding (covering myself and co-authors): This work was supported by the Medical Research Council (MC_UU_00022/2), Chief Scientist Office (SPHSU17), an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), and the Wellcome Trust (205412/Z/16/Z). The alcohol use variables in MCS5 were co-funded by grant AA019606 from the U.S. National Institute on Alcohol Abuse and Alcoholism. The funders played no active role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Graham Wheeler: I am a Statistical Ambassador of the Royal Statistical Society. I am employed by GSK, a pharmaceutical company, and hold an honorary senior lecturer position at Imperial College London’s School of Public Health.


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