Tobacco companies marketing e-cigarettes and nicotine pouches have tapped into social media and influencer culture to reach teens nationwide.

During an APHA 2025 session, “Youth and School-Based Prevention and Messaging for Tobacco and Alcohol Prevention,” experts showcased successful efforts to push back against the industry’s digital playbook.

A Food and Drug Administration public education campaign has proven success showcasing the negative health effects and risks of vaping and smoking to teens digitally, according to Leeann Siegel, a communications research scientist at RTI International.

Nationwide, almost 8% of high schoolers and 3.5% of middle schoolers use e-cigarettes. That represents more than 1.6 million youths.

Recognizing the changing trend of tobacco administration among teens early on, FDA centralized the focus of its “Real Cost Campaign” on e-cigarette messaging in 2017. The campaign warned teens about the likely heath impacts of using tobacco through jarring images. 

About three-quarters of youths reported seeing a campaign advertisement related to e-cigarette use, said Siegel, an author of the March 2025 report published in the American Journal of Preventive Medicine. 

Hispanic teens and those with psychological distress conditions were more likely to report ad awareness compared to the general population. Those who reported campaign brand awareness were more likely to be between ages 15 and 17 and from higher-income households.

The findings concluded that the campaign’s e-cigarette prevention ads decreased the probability of e-cigarette initiation, preventing an estimated 444,252 youths from initiating e-cigarette use. 

Nicotine pouches marketed to teens

While e-cigarettes have gained momentum over the past decade, nicotine pouches have recently entered the digital marketing scene; they entered the consumer market in 2014, targeting many of the same young consumers.

Current use of nicotine pouches among teens was about 2% in 2024. That’s more than 1% higher than 2021. 

Tobacco companies have tactically clung to influences, coined “Zynfluencers” to raise awareness of their product to young people. There influencers have used catchy nicknames for the products and promoted inner circles for people using the products.

Rescue, a health agency focused on behavior change, has found a successful formula for countering these advertisements, according to Samantha Jacobs, health communications senior director at Rescue.

The agency launched the campaign “The Nic Report,” leveraging social media tactics to promote nicotine pouch cessation.

Authenticity is central to the campaign, Jacobs said. Campaign videos advertisements mimic person-on-the-street videos often seen on social media platforms to make the advertisement feel real, not rehearsed.

The campaign attempts to respect teens’ intelligence and experiences and to not appear patronizing by avoiding generic or commonly known information.

Message testing of the Rescue approach shows promising results. “Seeing someone walk up to somebody with the mic and then talking usually tends to keep people’s attention,” a teen focus group participant said. 

Photo by Mixetto, courtesy iStockphoto.