The Association between Social Media Use, Mental Illness, and Vaping and Smoking

Background: This study examined the association between multiple dimensions of social media use and mental health concerns on nicotine dependency among people who vape and people who smoke. Vaping or smoking has drastically increased in Canada and the United States, which remains concerning as both vaping and smoking are associated with serious health concerns. Social media use and mental health concerns have been linked with vaping and smoking. Yet, there is still limited knowledge as to the interaction between these factors on both vaping and smoking behaviors. Thus, based on the harm of vaping and smoking, it is essential to understand the various factors that contribute to cigarette and e-cigarette use.

Methods: Cross-sectional data were collected using an online survey consisting of validated scales of social media use (e.g., engagement, dependency, frequency of use, and platforms used), mental illness (e.g., anxiety, depression), vaping nicotine dependency, and smoking nicotine dependency. A convenience sample of 707 English-speaking Canadian adults were recruited from Reddit, with 207 people who reported vaping and 95 who reported smoking. The sample was predominately White (80.8%), males (55.3%), with an average age of 30.80 (SD=9.15).

After completing descriptive and bivariate analyses, we conducted a confirmatory factor analysis (CFA) to develop a latent construct of social media use. Next, structural equational model (SEM) analyses were conducted to examine the association between social media use and vaping/smoking dependency, as mediated by anxiety and depression. Models for smoking and vaping dependency were run separately.

Results: The CFA indicated a good fitting model for the latent construct of social media use (χ² =5.41, p= 0.02, CFI=0.99, RMSEA=0.08).The vaping and smoking SEM showed also good fit (χ² =15.51, p=0.09, CFI=0.98, RMSEA=0.06, and χ² =11.31, p=0.42, CFI=0.99, RMSEA=0.02 respective). The vaping and smoking SEMs both accounted for 12.4% of the variance in nicotine dependency. In both models increased social media use was associated with great levels of mental health concerns, and greater levels of mental health concerns were associated with nicotine dependency. However, the smoking SEM showed a direct negative relationship between social media use and nicotine dependency (β=-0.42, p=0.02), whereas the vaping SEM showed no direct impact of social media use on nicotine dependency (p >0.05). Instead, the vaping SEM revealed an indirect positive association on nicotine dependency as mediated through mental health concerns (β=0.57, 0.34, p<0.001).

Implications: The finding from these models suggest that greater levels of social media use had differential impacts on nicotine dependency among those who smoke compare to those who vape. In both models, mental health concerns played a significant mediating role between social media use and nicotine dependency. Understanding factors related to nicotine dependency are critical for social workers in developing clinically-tailored interventions that attend to the direct and indirect factors leading to cigarette and e-cigarette use. Future studies should consider the temporal order of these factors, as well as the impact of different social media content.