E-cigarette use and promotion by social media influencers during videogame play on Twitch

Abstract

E-cigarette consumption among adolescents around the world, including the USA, is a public health concern.1–3 Exposure to social influencer content and other promotional strategies has been associated with increased risk of e-cigarette use among adolescents and young adults.4–7 One factor contributing to the uptake of e-cigarette use among adolescents is the industry’s overt and covert promotional strategies, including the use of influencers, that target teenagers. Influencers (eg, public figures, promoters, models, bloggers, brand ambassadors with followers of 1000 users or more)8–10 promote e-cigarette products11–13 on behalf of tobacco brands for monetary compensation or other rewards14–17 on social media platforms that are popular among youth (eg, Instagram, YouTube, TikTok, Twitch).13 18–25 We recently discovered evidence of use and promotion of e-cigarettes by influencers on Amazon-owned Twitch, a video-sharing platform, which is similar to YouTube, but caters more to live streamers as opposed to creators of stored, long-lasting content.26 Twitch is predominantly a video gaming platform, where audiences watch …