How Does Media Literacy Affect Smoking and Vaping Behaviors among Adolescents? A Systematic Literature Review

  • Danang Wahansa Sugiarto Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
  • Fajrin Violita Faculty of Public Health, Universitas Cenderawasih, Jayapura, Papua, Indonesia
Keywords: Media Literacy, Adolescent, Smoking, Vaping

Abstract

Introduction: Smoking remains a global health problem. In addition to conventional cigarettes, a new type of cigarette has emerged called electronic cigarettes (e-cigarettes or vapes). It is known that media exposure greatly influences adolescents' initiation into smoking. Based on this, a concept and intervention called media literacy was developed. This study examines how media literacy is measured or implemented in adolescents' smoking behavior, both conventional and electronic.

Methods: This study is a systematic literature review, and a review protocol based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) was used. A literature search using 4 reputable databases, namely Scopus, PubMed, Sage Journal, and Wiley Online Library, yielded 215 article findings. After the screening and review process, 7 eligible articles were selected based on the inclusion and exclusion criteria.

Results: From the 7 selected research articles, it was found that media literacy has a positive relationship or influence on adolescent smoking behavior. This is evident from various research findings that show media literacy can increase knowledge and awareness of depictions of encouragement to smoke in the media they see and/or hear. These results were found from research on 4 continents, and no research results from the African and South American continents met the inclusion criteria.

Conclusion: It is shown that media literacy is considered effective in increasing adolescents' knowledge and awareness of how the media tries to persuade them to try smoking, continue smoking, or vape. The results suggest developing learning modules or curricula that introduce and discuss media literacy in schools, either intracurricular, co-curricular, or extracurricular. Suggestions for future research include developing media literacy research tailored to local wisdom conditions and its application to measure or intervene in other risky health behaviors.

References

WHO. Tobacco; 2025. [Online] Available at: https://www.who.int/news-room/fact-sheets/detail/tobacco (Accessed on: July 2025).

WHO. Tobacco: E-Cigarettes; 2024. [Online] Available at: https://www.who.int/news-room/questions-and-answers/item/tobacco-e-cigarettes (Accessed on: July 2025).

Leonardi-Bee, J., Nderi, M., Britton, J. Smoking in movies and smoking initiation in adolescents: systematic review and meta-analysis. Addiction, 2016; 111(10): 1750-1763. DOI: 10.1111/add.13418.

Voorhees, CC., Ye, C., Carter-Pokras, O., MacPherson, L., Kanamori, M., Zhang, G., et al. Peers, Tobacco Advertising, and Secondhand Smoke Exposure Influences Smoking Initiation in Diverse Adolescents. American Journal of Health Promotion, 2011; 25(3): e1-e11. DOI: 10.4278/ajhp.090604-QUAN-180.

Stead, M., Angus, K., Langley, T., Katikireddi, SV., Hinds, K., Hilton, S., et al. Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence. Public Health Res, 2019; 7(8). DOI: 10.3310/phr07080.

Buckingham, D. Media Education: Literacy, Learning, and Contemporary Culture. Malden, MA: Blackwell Publishing; 2003.

Hoechsmann, M., Poyntz, SR. Media Literacies: A Critical Introduction. New Jersey: Blackwell Publishing; 2012.

Primack, BA., Gold, MA., Switzer, GE., Hobbs, R., Land, SR., Fine, MJ. Development and Validation of a Smoking Media Literacy Scale for Adolescents. Arch Pediatr Adolesc Med, 2006; 160(4): 369-374. DOI: 10.1001/archpedi.160.4.369.

Manganello, JA. Health literacy and adolescent: a framework and agenda for future research. Health Education Research, 2008; 23(5): 840-847. DOI: 10.1093/her/cym069.

PRISMA. PRISMA 2020 statement; 2024. Available at: https://www.prisma-statement.org/prisma-2020 (Accessed on: May 2025).

Braun, V., Clarke, V. Using thematic analysis in psychology. Qualitative Research in Psychology, 2006; 3(2): 77–101. DOI: 10.1191/1478088706qp063oa.

Heriyanto, H. Thematic Analysis sebagai Metode Menganalisa Data untuk Penelitian Kualitatif. ANUVA, 2018; 2(3): 317-324. DOI: 10.14710/anuva.2.3.317-324.

DATAtab. Cohen’s Kappa; 2025. Available at: https://datatab.net/tutorial/cohens-kappa (Accessed on: June 2025).

Park, S., Lee, H. School-Based Intervention of Smoking Media Literacy Among South Korean Adolescents: A Cluster Randomized Trial. Asian Nursing Research, 2025; 3: 1-29. DOI: 10.1016/j.anr.2025.03.001.

Kim, S. Using Intervention Mapping to Develop a Media Literacy-Based Smoking Prevention Program for Female Adolescents. Int. J. Environ. Res. Public Health, 2021; 18: 6305. DOI: 10.3390/ijerph18126305.

Dai, HD., Kerns, E., Niebur, H., Deschamp, A., Johnson, R., Samson, K., et al. Developing a media literacy-based e-cigarette education program via medical record systems. Tob. Prev. Cessation, 2025; 11(April): 22. DOI: 10.18332/tpc/201477.

Lazea, C., Popa, A., Varga, C. Association between Internet Use Behavior and Palpitation among Adolescents: A Cross-Sectional Study of Middle School Children from Northwest Romania. Int. J. Environ. Res. Public Health, 2020; 17: 4278. DOI: 10.3390/ijerph17124278.

Sadza, A., Daalmans, S., Rozendaal, E., Bujizen, M. Mediated risks through rose-tinted glasses? Exploring barriers and boosters to critical deconstructions of mediated risk behavior by Dutch adolescents. Journal of Communication, 2024; 74: 374-386. DOI: 10.1093/joc/jqae025.

Michaud, T., Puga, T., Archer, R., Theye, E., Zagurski, C., Estabrooks, P., et al. Enhancing Text Message Support with Media Literacy and Financial Incentives for Vaping Cessation in Young Adults: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc, 2025; 14: e60527. DOI: 10.2196/60527.

Zahrai, K., Veer, E., Ballantine, PW., de Vries, HP., Prayag, G. Either you control social media or social media controls you: Understanding the impact of self-control on excessive social media use from the dual-system perspective. J Consum Aff, 2022; 56: 806–848. DOI: 10.1111/joca.12449.

Canadian Paediatric Society. Impact of media use on children and youth. Paediatr Child Health, 2003; 8(5): 301-306. DOI: 10.1093/pch/8.5.301.

Rideout, VJ., Foehr, UG., Roberts, DF. Generation M2: Media in the Lives of 8- to 18-Year-Olds; A Kaiser Family Foundation Study, January 2010. California: Kaiser Family Foundation; 2010.

American College of Pediatricians. Media Use and Screen Time – Its Impact on Children, Adolescents, and Families; 2020. [Online] Available at: https://acpeds.org/media-use-and-screen-time-its-impact-on-children-adolescents-and-families/ (Accessed on: August 2025).

Perera, A. Cultivation Theory in Media; 2023. [Online] Available at: https://www.simplypsychology.org/cultivation-theory.html (Accessed on: July 2025).

DiFranza, JR., Wellman, RJ., Sargent, JD., Weitzman, M. Hipple, BJ., Winickoff, JP., et al. Tobacco promotion and the initiation of tobacco use: assessing the evidence for causality. Pediatrics, 2006; 117: 1237-1248. DOI: 10.1542/peds.2005-1817.

U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of The Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.

Geraee, N., Kaveh, MH., Shojaeizadeh, D. Tabatabaee, HR. Impact of media literacy education on knowledge and behavioral intention of adolescents in dealing with media messages according to Stages of Change. J Adv Med Educ Prof, 2015; 3(1): 9-14.

Montazeri, L., Eslami, H., Afshani, SA. Role of Students’ Media Literacy on Their Health: A Narrative Review. Role of Students’ Media Literacy on Their Health: A Narrative Review. Journal of Community Health Research, 2022; 11(1): 45-53. DOI: 10.18502/jchr.v11i1.9095.

Nurjanah, N., Sugihantono, A., Widjanarko, B., Handayani, N., Musthofa, SB., Puspitaningtyas, SI., et al. TAPS Ban and Media Literacy to Protect Youth from Tobacco Industry Inducement. Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, 2025; 13(SI 2): 135-142. DOI: 10.20473/jpk.V13.ISI2.2025.135-142.

World Health Organization. Global Youth Tobacco Survey 2019 Factsheets; 2020. [Online] Available at: https://cdn.who.int/media/docs/default-source/searo/tobacco/global-youth-tobacco-survey/gyts-indonesia-extended-factsheet.pdf?sfvrsn=d202f34f_3 (Accessed on: August 2025).

World Health Organization. World No Tobacco Day 2025: WHO hails Indonesia’s bold reforms, calls for decisive action on standardized packaging; 2025. [Online] Available at: https://www.who.int/indonesia/news/detail/30-05-2025-world-no-tobacco-day-2025--who-hails-indonesia-s-bold-reforms--calls-for-decisive-action-on-standardized-packaging#:~:text=Key%20provisions%20include%20raising%20the,and%20additives%2C%20and%20banning%20tobacco (Accessed on: August 2025).

Australian Government, Department of Health, Disability, and Ageing. New legislation for tobacco and other products; 2023. [Online] Available at: https://www.health.gov.au/topics/smoking-vaping-and-tobacco/tobacco-control/new-legislation#:~:text=Control%20(FCTC).-,Key%20elements%20of%20the%20new%20laws,within%20the%20Australian%20Border%20Force (Accessed on: August 2025).

Lange, T., Hoefges, M., Ribisl, KM. Regulating Tobacco Product Advertising and Promotions in the Retail Environment: A Roadmap for States and Localities. J Law Med Ethics, 2015; 43(4): 878–896. DOI: 10.1111/jlme.12326.

Pradnyana, PY., Ekaputra, IWGA. Effectiveness of Television Cigarette Advertising Regulation Based on Minister of Health Regulation No. 56/2017 Concerning the Inclusion of Health Warnings and Health Information on Tobacco Product Packaging. JLPH: Journal of Law, Politics, and Humanities, 2025; 5(4): 2413-2420. DOI: 10.38035/jlph.v5i4.1515.

Bier, MC., Schmidt, SJ., Shields, D., Zwarun L., Sherblom, S., Primack, B., et al. School-based smoking prevention with media literacy: A pilot study. Journal of Media Literacy Education, 2010; 2(3): 185–198. DOI: 10.23860/jmle-2-3-1.

Primack, BA., Gold, MA., Land, SR., Fine, MJ. Association of Cigarette Smoking and Media Literacy about Smoking among Adolescents. J Adolesc Health, 2006; 39(4): 465–472. DOI: 10.1016/j.jadohealth.2006.05.011.

Primack, BA., Hobbs, R. Association of various components of media literacy and adolescent smoking. Am J Health Behav, 2009; 33(2):192–201. DOI: 10.5993/ajhb.33.2.8.

Salgado, MV., Perez-Stable, EJ., Primack, BA., Kaplan, CP., Meija, RM., Gregorich, SE., et al. Association of media literacy with cigarette smoking among youth in Jujuy, Argentina. Nicotine Tob Res, 2011; 14(5): 516–521. DOI: 10.1093/ntr/ntr240.

Page, RM., Huong, NT., Chi, HK., Tien, TQ. Smoking media literacy in Vietnamese adolescents. J Sch Health, 2011; 81(1): 34–41. DOI: 10.1111/j.1746-1561.2010.00555.x.

Page, RM., Piko, BF., Balazs, MA., Struk T. Media literacy and cigarette smoking in Hungarian adolescents. Health Education Journal, 2010; 70(4): 446–457. DOI: 10.1177/0017896910379692.

Sugiarto, DW., Ayubi, D., Martha, E. Hubungan smoking media literacy dengan status merokok siswa menengah atas. Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior, 2020; 2(1): 18-28. DOI: 10.47034/ppk.v2i1.3973.

Bier, MC., Zwarun, L., Sherblom, SA. Evidence of the Value of the Smoking Media Literacy for Middle School Students. J Sch Health, 2016; 86(10): 717-725. DOI: 10.1111/josh.12425.

Primack, BA., Sidani, J., Carroll, MV., Fine, MJ. Associations between Smoking and Media Literacy in College Students. J Health Commun, 2009; 14(6): 541–555. DOI: 10.1080/10810730903089598.

Aienobe?Asekharen, C., Norris, E., Martin, W. A Scoping Review of Tobacco Control Health Communication in Africa: Towards Involving Young People. Int J Environ Res Public Health, 2024; 21(3): 259. DOI: 10.3390/ijerph21030259.

Canada’s Center for Digital Media Literacy. USE, UNDERSTAND & ENGAGE: A Digital Media Literacy Framework for Canadian Schools – Overview; n.d. [Online] Available at: https://mediasmarts.ca/teacher-resources/digital-literacy-framework/digital-literacy-framework-overview (Accessed on: August 2025).

California Department of Education. Media Literacy Resources; n.d. [Online] Available at: https://www.cde.ca.gov/wafalert.html?_event_transid=05a45cc7530138b7236e1f018e8ae27aed54a61b6b4de5ddb5b4079bcb8003d6 (Accessed on: August 2025).

Published
2025-10-04
How to Cite
Sugiarto, D. W., & Violita, F. (2025). How Does Media Literacy Affect Smoking and Vaping Behaviors among Adolescents? A Systematic Literature Review . Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(10), 1204-1216. https://doi.org/10.56338/mppki.v8i10.8113