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This study examined prospective associations between exposure to and engagement with nicotine\/tobacco-related social media content and nicotine\/tobacco use among young adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Methods<\/jats:title>\n                    <jats:p>Young adults (N = 2080) originally recruited from Southern California high schools for a prospective cohort study reported frequency of viewing and posting nicotine\/tobacco content on four social media platforms (Facebook, Instagram, Twitter, and YouTube). Participants also reported frequency of seeing nicotine\/tobacco posts from friends, seeing nicotine\/tobacco posts from influencers or celebrities, and liking nicotine\/tobacco posts. Within subsamples of nicotine\/tobacco never users (n = 794), past users (n = 897) and current users (n = 389), analyses examined associations of baseline (May\u2013October 2020) social media content exposure and engagement with follow-up (January\u2013June 2021) tobacco use initiation (among never users), resumption (among past users), and continuation (among current users), adjusting for sociodemographic and socioenvironmental characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Never users who saw nicotine\/tobacco posts from friends (Adjusted Odds Ratio [AOR] = 2.91 [95% Confidence Interval [CI]: 1.46, 5.82], p = .002) or from celebrities or influencers (AOR = 2.77 [1.32, 5.84], p = .007) were significantly more likely to initiate nicotine\/tobacco use than their peers. Among past users, posting nicotine\/tobacco content at baseline was associated with use resumption (AOR = 1.77 [1.12, 2.80], p = .014). Content exposure and engagement were not associated with nicotine\/tobacco use continuation among current users (p-values &amp;gt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Seeing nicotine\/tobacco posts from friends, influencers, or celebrities was associated with greater odds of tobacco use initiation, but not resumption or continuation, 6 months later. Young adults with past nicotine\/tobacco use who post about nicotine\/tobacco may be at elevated risk for resuming use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Young adults with exposure to nicotine\/tobacco social media content were more likely than their peers to initiate nicotine\/tobacco use 6 months later. Past nicotine\/tobacco users who reported posting about nicotine\/tobacco on social media at baseline were more likely than their peers to resume nicotine\/tobacco use. Among young adults with current nicotine\/tobacco use at baseline, social media activity did not predict odds of nicotine\/tobacco use continuation at follow-up. Nicotine\/tobacco content on social media should be restricted to reduce young people\u2019s chances of nicotine\/tobacco use initiation or resumption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntad108","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T10:17:37Z","timestamp":1688033857000},"page":"S3-S12","source":"Crossref","is-referenced-by-count":38,"title":["Young Adults\u2019 Exposure to and Engagement With Tobacco-Related Social Media Content and Subsequent Tobacco Use"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-8720","authenticated-orcid":false,"given":"Erin A","family":"Vogel","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine , San Francisco, Los Angeles, CA , USA"},{"name":"Institute for Addiction Science, University of Southern California , Los Angeles, CA , 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