Social media–based interventions to prevent adolescent nicotine use: a scoping review

Abstract

Despite growing concerns about adolescent nicotine use, the evidence regarding the outcomes of social media–based prevention efforts remains underexplored. This scoping review maps the scope, characteristics, and outcomes of (i) social media–based prevention interventions and (ii) educational interventions addressing adolescents’ interpretation of nicotine-related social media content. PubMed, PsycINFO, Scopus, ERIC, and CINAHL were systematically searched in March 2024 and updated in November 2025. Peer-reviewed English-language articles published since 2006 were included; cessation-focused studies were excluded. Of 1626 records screened by two independent reviewers, 18 studies met inclusion criteria. A structured codebook guided data extraction. The 18 included studies encompassed a wide range of designs, including online experiments, longitudinal and cross-sectional studies, content analyses, and qualitative research. Interventions ranged from message testing and simulated social media exposure to large-scale public health campaigns (e.g. “Rethink Vape,” “Truth,” “The Real Cost,” and “Fresh Empire”), alongside one school-based media literacy program (“MediaSense”). Most studies reported short-term improvements in knowledge, risk perception, or engagement, whereas evidence for sustained behavior change or reduced nicotine use was limited. Common limitations included reliance on self-reported outcomes and short follow-up periods. Most studies reported improvements in knowledge and risk perceptions, whereas evidence for sustained behavioral outcomes remains methodologically heterogeneous and largely focused on short-term outcomes. More rigorous longitudinal evaluations and sustained public health investment are needed. For practitioners and policymakers, the findings support investment in culturally tailored, platform-native campaigns alongside stronger regulatory frameworks to limit adolescents’ exposure to nicotine-related marketing in digital environments.