{"doi":"10.1093/ntr/ntab099","title":"Negative Perceptions of Young People Using E-Cigarettes on Instagram: An Experiment With Adolescents","abstract":"INTRODUCTION: Although e-cigarette marketing on social media increases positive attitudes and experimentation, little is known about non-influencer e-cigarette portrayals of young people. AIMS AND METHODS: High school adolescents (n = 928, 15-18) were recruited by Lightspeed Health for an online experiment and randomized to view an Instagram post with or without e-cigarette use. Outcomes were positive and negative perceptions (prototypes), social distance, and willingness to use. RESULTS: Half (50%) of participants were susceptible to e-cigarette use. E-cigarettes shown (vs. not) led to less positive prototypes, p = .017, more negative prototypes, p = .004, and more social distance, p < .001. Negative prototypes and social distance were moderated by susceptibility (both p < .05); effects among non-susceptible adolescents only. Showing e-cigarettes did not impact willingness to use if offered. CONCLUSIONS: Negative perceptions of e-cigarettes use challenge assumptions that vaping online is universally admirable. Highlighting unfavorable opinions of vaping or negative impacts for adolescents' social image are potential strategies for tobacco counter-marketing. IMPLICATIONS: Despite daily use of visual-based social media by most adolescents, little is known about the influence of e-cigarette use among young people online. Adolescent negative perceptions and desired distance from non-influencers using e-cigarettes on Instagram indicate digital e-cigarette portrayals are not universally accepted. Negative impacts for adolescents' social image present a counter-marketing strategy.","journal":"Nicotine & Tobacco Research","year":2021,"id":184829,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9604,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":740240,"name":"Sydney Nicolla","orcid":"0000-0002-3167-6623","position":1,"is_corresponding":false},{"id":740740,"name":"Avery Darida","orcid":null,"position":2,"is_corresponding":false},{"id":245040,"name":"Marissa G. Hall","orcid":"0000-0002-8690-9498","position":3,"is_corresponding":false},{"id":282009,"name":"Allison J. Lazard","orcid":"0000-0002-2502-2850","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-18T23:48:30.970730Z","pmid":"33990843","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}