E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors

Abstract Background Youth behavior is significantly influenced by their social environment and social media (SM). Susceptibility to e-cigarette use, defined as the likelihood of initiating e-cigarette use among non-users, is a critical early marker for prevention efforts. This study explores the int...

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Main Authors: Mouhamad Bigwanto, Melinda Pénzes, Nurul Kodriati, Emma Rachmawati, Nida Amalia, Róbert Urbán
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-24013-3
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author Mouhamad Bigwanto
Melinda Pénzes
Nurul Kodriati
Emma Rachmawati
Nida Amalia
Róbert Urbán
author_facet Mouhamad Bigwanto
Melinda Pénzes
Nurul Kodriati
Emma Rachmawati
Nida Amalia
Róbert Urbán
author_sort Mouhamad Bigwanto
collection DOAJ
description Abstract Background Youth behavior is significantly influenced by their social environment and social media (SM). Susceptibility to e-cigarette use, defined as the likelihood of initiating e-cigarette use among non-users, is a critical early marker for prevention efforts. This study explores the interplay of social environment, SM marketing exposure, and individual traits in e-cigarette use and susceptibility among Indonesian youth, addressing a gap in non-Western contexts. Methods A school-based online survey of 1,600 Indonesian youth aged 15–24, conducted from March to August 2023 in Jakarta, Yogyakarta and East Kalimantan, assessed e-cigarette use, susceptibility, and predictors, including social environment, SM marketing exposure, and sensation-seeking behavior. Structural equation modeling and multinomial regression were used to analyze associations. Results Approximately 13.3% of students reported using e-cigarettes in the past 30 days, and 6.7–10.1% of non-users were susceptible to experimenting with e-cigarettes. Boys were significantly more likely than girls to be current (OR = 6.67, 95% CI [3.05–14.57]) and ever e-cigarette users (OR = 2.92, 95% CI [2.10–4.06]). Sensation-seeking (OR = 2.19, 95% CI [1.83–2.62]), e-cigarette use by horizontal family member (OR = 1.39, 95% CI [1.10–1.53]), number of friends using e-cigarettes (OR = 1.20, 95% CI [1.17–1.23]), and exposure to e-cigarette advertisements on Instagram and TikTok (OR = 1.35, 95% CI [1.20–1.53]) were significant predictors of current use. Among non-users, boys reported higher susceptibility to e-cigarette use than girls (β = 0.20, p <.01). Sensation seeking (β = 0.24, p <.01) and the number of friends using e-cigarettes (β = 0.22, p <.01) were directly associated with susceptibility. Sex-specific patterns were observed: maternal and sisters’ e-cigarette use were associated with increased susceptibility among girls (r =.11, p =.002; r =.17, p <.001), while grandfathers’ use was linked to higher susceptibility among boys (r =.21, p <.001). Notably, TikTok exposure was uniquely associated with greater susceptibility among girls (r =.08, p =.023). Conclusions SM, peers, and family significantly shape youth e-cigarette-related behavior. These findings underscore the need for targeted interventions, including banning e-cigarette advertising on SM, promoting peer-driven prevention strategies, and leveraging SM for educational campaigns to reduce youth e-cigarette use.
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spelling doaj-art-4749715209d546eaa79b3da3a9f86b052025-08-20T03:43:34ZengBMCBMC Public Health1471-24582025-08-0125111310.1186/s12889-025-24013-3E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factorsMouhamad Bigwanto0Melinda Pénzes1Nurul Kodriati2Emma Rachmawati3Nida Amalia4Róbert Urbán5Doctoral School of Psychology, Eötvös Loránd UniversityData-Driven Health Division of the National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis UniversityFaculty of Public Health, University of Ahmad DahlanFaculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. HAMKAFaculty of Public Health, Universitas Muhammadiyah Kalimantan TimurDoctoral School of Psychology, Eötvös Loránd UniversityAbstract Background Youth behavior is significantly influenced by their social environment and social media (SM). Susceptibility to e-cigarette use, defined as the likelihood of initiating e-cigarette use among non-users, is a critical early marker for prevention efforts. This study explores the interplay of social environment, SM marketing exposure, and individual traits in e-cigarette use and susceptibility among Indonesian youth, addressing a gap in non-Western contexts. Methods A school-based online survey of 1,600 Indonesian youth aged 15–24, conducted from March to August 2023 in Jakarta, Yogyakarta and East Kalimantan, assessed e-cigarette use, susceptibility, and predictors, including social environment, SM marketing exposure, and sensation-seeking behavior. Structural equation modeling and multinomial regression were used to analyze associations. Results Approximately 13.3% of students reported using e-cigarettes in the past 30 days, and 6.7–10.1% of non-users were susceptible to experimenting with e-cigarettes. Boys were significantly more likely than girls to be current (OR = 6.67, 95% CI [3.05–14.57]) and ever e-cigarette users (OR = 2.92, 95% CI [2.10–4.06]). Sensation-seeking (OR = 2.19, 95% CI [1.83–2.62]), e-cigarette use by horizontal family member (OR = 1.39, 95% CI [1.10–1.53]), number of friends using e-cigarettes (OR = 1.20, 95% CI [1.17–1.23]), and exposure to e-cigarette advertisements on Instagram and TikTok (OR = 1.35, 95% CI [1.20–1.53]) were significant predictors of current use. Among non-users, boys reported higher susceptibility to e-cigarette use than girls (β = 0.20, p <.01). Sensation seeking (β = 0.24, p <.01) and the number of friends using e-cigarettes (β = 0.22, p <.01) were directly associated with susceptibility. Sex-specific patterns were observed: maternal and sisters’ e-cigarette use were associated with increased susceptibility among girls (r =.11, p =.002; r =.17, p <.001), while grandfathers’ use was linked to higher susceptibility among boys (r =.21, p <.001). Notably, TikTok exposure was uniquely associated with greater susceptibility among girls (r =.08, p =.023). Conclusions SM, peers, and family significantly shape youth e-cigarette-related behavior. These findings underscore the need for targeted interventions, including banning e-cigarette advertising on SM, promoting peer-driven prevention strategies, and leveraging SM for educational campaigns to reduce youth e-cigarette use.https://doi.org/10.1186/s12889-025-24013-3Electronic cigarettesSocial environmentSocial media marketingYouthStudentIndonesia
spellingShingle Mouhamad Bigwanto
Melinda Pénzes
Nurul Kodriati
Emma Rachmawati
Nida Amalia
Róbert Urbán
E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors
BMC Public Health
Electronic cigarettes
Social environment
Social media marketing
Youth
Student
Indonesia
title E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors
title_full E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors
title_fullStr E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors
title_full_unstemmed E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors
title_short E-cigarette use and susceptibility among Indonesian youth: the role of social environment, social media, and individual factors
title_sort e cigarette use and susceptibility among indonesian youth the role of social environment social media and individual factors
topic Electronic cigarettes
Social environment
Social media marketing
Youth
Student
Indonesia
url https://doi.org/10.1186/s12889-025-24013-3
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