{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:20:56Z","timestamp":1793035256128,"version":"4.5.0"},"reference-count":65,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Adolescents are exposed to e-cigarette and cannabis content on social media. Understanding associations of these exposures with use and dual use of these products can guide regulations.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess whether adolescent exposure to e-cigarette and\/or cannabis content on social media, including posts by various content creators, is associated with e-cigarette, cannabis, and dual use.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Two surveys, one longitudinal (study 1, baseline in 2021 to 2022) and one cross-sectional (study 2, fall 2023), were conducted among California high school students who completed questionnaires on computers in classrooms.<\/jats:p><\/jats:sec>Exposures<\/jats:title>In study 1, the baseline was frequent exposure (weekly or more vs less frequent or none) to e-cigarette and\/or cannabis social media posts. In study 2, the exposure (yes vs no) was to e-cigarette and\/or cannabis posts from specific sources (friends, celebrities, microinfluencers, e-cigarette and\/or cannabis brands, or unknown sources).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>For study 1, the primary outcome was solo e-cigarette, solo cannabis, or dual use initiation at 1-year follow-up among baseline never-users of e-cigarettes and cannabis. For study 2, the primary outcome was past-month use of e-cigarettes, cannabis, and dual use. Generalized estimating equations models adjusted for sociodemographic characteristics, mental health, other tobacco product use, social media use, and social environment.<\/jats:p><\/jats:sec>Results<\/jats:title>In study 1, of 4232 adolescents (mean [SD] age, 17.0 [0.6] years; 2205 female [52.1%]), 968 (22.9%) reported frequent baseline exposure to e-cigarette posts and 507 (12.0%) reported exposure to cannabis posts on social media, broadly; 567 (13.4%) were frequently exposed to e-cigarette posts specifically on TikTok. Frequent exposure to cannabis social media posts was associated with solo e-cigarette use (adjusted odds ratio [AOR], 1.83; 95% CI, 1.11-3.01), solo cannabis use (AOR, 1.60; 95% CI, 1.07-2.38), and dual use (AOR, 1.71; 95% CI, 1.11-2.63) initiation at 1-year follow-up. Frequent exposure to e-cigarette posts on TikTok was associated with solo cannabis use (AOR, 1.74; 95% CI, 1.17-2.58) and dual use (e-cigarette and cannabis) initiation (AOR, 1.78; 95% CI, 1.19-2.66). In study 2, of 3380 adolescents (mean [SD] age, 17.0 [0.6] years; 1840 female [54.4%]), 195 (5.8%) were exposed to microinfluencer e-cigarette posts, and 152 (4.5%) were exposed to microinfluencer cannabis posts; 151 (4.5%) were exposed to friends\u2019 e-cigarette posts, and 161 (4.8%) were exposed to friends\u2019 cannabis posts. Exposure to e-cigarette (AOR, 2.67; 95% CI, 1.55-4.59) and cannabis (AOR, 2.14; 95% CI, 1.15-4.00) microinfluencer posts was associated with past-month cannabis use. Exposure to friends\u2019 e-cigarette posts was associated with past-month dual use (AOR, 2.53; 95% CI, 1.24-5.19), whereas exposure to friends\u2019 cannabis posts was associated with past-month cannabis use (AOR, 3.35; 95% CI, 1.94-5.78) and dual use (AOR, 2.46; 95% CI, 1.28-4.71).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this survey study of California adolescents, exposure to e-cigarette or cannabis posts was associated with adolescent e-cigarette, cannabis, or dual use. Improvement of social media community guidelines and greater policy attention to co-use and marketing of e-cigarettes and cannabis may help prevent youth substance use.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.17611","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T15:01:22Z","timestamp":1750777282000},"page":"e2517611","source":"Crossref","is-referenced-by-count":20,"title":["E-Cigarette and Cannabis Social Media Posts and Adolescent Substance Use"],"prefix":"10.1001","volume":"8","author":[{"given":"Julia","family":"Vassey","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los 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