Influencer Marketing and Adolescent E-cigarette Use

The Effect of Social Media Influencer Marketing on E-cigarette Perceptions and Use by Adolescents.

Adolescents (N = 700) participated in the online survey-based randomized experiment focused on understanding youth perceptions of e-cigarette influencer marketing on social media. Specifically, the study assessed how age appearance of social media influencers, fitness-related contextual framing of e-cigarette content, and perceived influencer credibility jointly shape adolescent harm perceptions, appeal, and susceptibility to e-cigarette use. Participants were randomly shown 6 videos, featuring younger- or older-looking influencers promoting e-cigarettes in the following experimental conditions: 1) younger-looking influencers promoting e-cigarettes alongside fitness-oriented activities (condition 1); 2) older-looking influencers promoting e-cigarettes alongside fitness-oriented activities (condition 2); 3) younger-looking influencers promoting e-cigarettes without any fitness-oriented content; and 4) older-looking influencers promoting e-cigarettes without any fitness-oriented content (control). After watching each video, participants rated perceptions of influencer credibility (i.e., honesty, trustworthiness, knowledge) on the scale of 0 (e.g., dishonest) to 100 (honest). Among all participants, harm perceptions and appeal of e-cigarettes was also assessed. Susceptibility to use e-cigarettes was assessed among never users of e-cigarettes.

Study Overview

• Status: Completed
• Conditions: Vaping
• Intervention / Treatment: Other: Youth Perceptions of Influencer Age and Fitness Contexts in E-Cigarette Marketing

Detailed Description

Adolescents (14-17 years of age) living in California were recruited by Qualtrics marketing research panel to participate in a survey on tobacco-related attitudes and behaviors. Qualtrics, a research panel agency, has been used in prior research to survey adolescents about their tobacco-related attitudes and behaviors. Participants were provided with a survey URL link. After completing informed consent, participants completed the survey online. The study was approved by the University of Southern California Institutional Review Board (UP-CG-24-00013). Respondents were randomly assigned to watch six 10-second long Instagram and/or TikTok videos in four experimental conditions: 1) younger-looking influencers promoting e-cigarettes alongside fitness-oriented activities (condition 1); 2) older-looking influencers promoting e-cigarettes alongside fitness-oriented activities (condition 2); 3) younger-looking influencers promoting e-cigarettes without any fitness-oriented content; and 4) older-looking influencers promoting e-cigarettes without any fitness-oriented content (control).

• Study Type: Interventional
• Enrollment (Actual): 700
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Washington
    • Seattle, Washington, United States, 98101
      • Qualtrics, survey was administered online

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 14-17 years of age,
• English fluency,
• Current California resident.

Exclusion Criteria:

Not meeting the following criteria:

• 14-17 years of age,
• English fluency,
• Current California resident.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Videos featuring young influencers promoting e-cigarettes alongside fitness-related activities; a 10 second video clip	Other: Youth Perceptions of Influencer Age and Fitness Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Videos featuring older influencers promoting e-cigarettes alongside fitness-related activities; a 10 second video clip	Other: Youth Perceptions of Influencer Age and Fitness Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Experimental: Videos featuring young influencers promoting e-cigarettes without fitness-related activities; a 10 second video clip	Other: Youth Perceptions of Influencer Age and Fitness Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.
Active Comparator: Videos featuring older influencers promoting e-cigarettes without fitness-related activities; a 10 second video clip	Other: Youth Perceptions of Influencer Age and Fitness Contexts in E-Cigarette Marketing; Participants watched online survey-imbedded promotional videos featuring influencers. Influencer age appearance was manipulated using AI-based age filter.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Harm Perceptions of e-cigarettes	Responses to one question adapted from PATH, "Based on the videos you just watched, do you think using e-cigarettes for vaping nicotine is harmful to your health?" The outcome was assessed on the 5-point ordinal scale with the following response choices: Not at all harmful, slightly harmful, somewhat harmful, very harmful, extremely harmful.	assessed six times immediately after each of the six videos during the 15-minute-long survey-based experiment
Perceived appeal of e-cigarettes	Description: Responses to the following questions: using e-cigarette is: not cool/cool, unattractive/attractive were assessed on the 7-point semantic differential scale with the word pairs anchored at each end. The scale was adapted from prior research. The items were combined (by summing all the non-missing values of the items) into one variable (α=0.94).	Assessed six times immediately after each of the six videos during the 15-minute-long survey-based experiment
Susceptibility to e-cigarette use	Susceptibility to e-cigarette use was measured (among never-users of e-cigarettes), using the validated three-item scale (indicating peer influence, intention, and curiosity about e-cigarette use) adapted from PATH, and combined into one variable (α=0.93). Consistent with prior research, the measure was dichotomized with responses "definitely not" to all items being coded as "not susceptible" and responses "probably not," "probably yes", or "definitely yes" being coded as "susceptible."	Assessed six times immediately after each of the six videos during the 15-minute-long survey-based experiment
Perceived influencer credibility	Perceived influencer credibility (i.e., honesty, trustworthiness, knowledge) were assessed using a 0 (e.g., dishonest) -100 (e.g., honest) scale that has been validated in prior research.	Assessed six times immediately after each of the six videos during the 15-minute-long survey-based experiment

Collaborators and Investigators

• Sponsor: University of Southern California
• Collaborators: Tobacco Related Disease Research Program
• Investigators: Principal Investigator: Jennifer B Unger, PhD, University of Southern California

Publications and helpful links

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): July 16, 2025
• Primary Completion (Actual): August 1, 2025
• Study Completion (Actual): August 1, 2025

Study Registration Dates

• First Submitted: February 1, 2026
• First Submitted That Met QC Criteria: February 11, 2026
• First Posted (Actual): February 19, 2026

Study Record Updates

• Last Update Posted (Actual): February 19, 2026
• Last Update Submitted That Met QC Criteria: February 11, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Smoking; Vaping
• Other Study ID Numbers: UP-CG-24-00013

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: survey is anonymous. Data will be publicly available on GitHub repository if a manuscript related to this study is accepted for publication

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No