By Patricia A. Cavazos-Rehg, PhD, Associate Professor of Psychiatry, School of Medicine


Social media use has surged over the past decade especially among young adults and teenagers.

Consumer surveys indicate that up to 80% of US adults are on social media and this prevalence is heavily driven by its popularity among young adults. Social media use among teenagers is also high. In fact, 70% of US teenagers use more than one social media site, and many spend at least an hour a day engaging with social media.

These are exciting trends for public health professionals who are focused on prevention efforts and/or adolescent health for three reasons especially:

  • First, young people are at a critical stage of development where peer and media can exert a strong influence on the behaviors and attitudes of young people.
  • Second, experimentation and involvement in health risk behaviors are likely to occur as teens are transitioning into young adulthood.
  • Third, there is great potential for the delivery of public health messages that can promote responsible behaviors and are streamed via social media to targeted populations.

However, health promotion messages should not be streamed on social media without careful thought about how they will effectively exploit the dynamics of information exchanges occurring on these platforms. In other words, health promotion messages must be delivered on social media in a strategic way where they are reaching their intended audience and engaging with them in a meaningful way.


Marijuana and Twitter

To illustrate this point, research from my lab has revealed a widely followed pro-marijuana presence on Twitter; we have not been able to identify a counterbalance. Specifically, we assessed the engagement, follower demographics and Tweet content of a popular Twitter handle about marijuana (WeedTweets@stillblazingtho).


Researchers find that the “Twitterverse” is a pot-friendly place.


We compared this handle with the Twitter handle for National Institute on Drug Abuse (NIDA) (NIDAnews@NIDAnews), which is linked from both the NIDA general website and NIDA’s teen website. WeedTweets had substantially more followers than NIDAnews (959,143 vs 17,509) and sent 5 times as many Tweets as NIDAnews during the 8-month period.

Tweets from WeedTweets were retweeted nearly 2 million times versus NIDAnews Tweets that were retweeted only 2,000 times. Potential impressions are the number of times the Tweet could have appeared in a Twitter feed, and were much higher for WeedTweets (almost 3 billion impressions versus @NIDAnews 12 million).

As a whole, our research signaled that WeedTweets has a much greater Twitter presence as indicated by their exponentially higher number of followers and retweets. We also identified that most Tweets from WeedTweets encouraged recreational marijuana use and involved humorous content about marijuana targeted towards youth and young adults. Most NIDA Tweets targeted researchers/clinicians or adults (65%); only 19% of NIDA’s Tweets were targeted to teens.

Though we discovered this strong pro-marijuana presence on Twitter through WeedTweets targeted at young adults, we did not identify a powerful voice on Twitter discouraging the use of marijuana. The NIDAnews Twitter handle targets researchers/clinicians who are a low risk audience for marijuana use. We inferred the demographic characteristics of these two contrasting Twitter profiles and found that the followers of NIDAnews tended to be older (35+ years old), Caucasian, and health/education professionals versus WeedTweets followers who were younger (24 years old and younger), African American or Hispanic, and are students. While this study was conducted in March 2014, a cursory scan of the Twitter profiles WeedTweets and NIDAnews even today do not indicate any changes in their disparate number of followers and/or content of Tweets.


Health Promotion Messages via Social Media

With so many young people on social media, it is certainly an exciting time for public health professionals to consider ways to deliver health promotion messages to target populations via social media. This can be especially critical for young people who are at a prime time in their development for engaging in risky behaviors such as drug use.


Our marijuana-related research described above signals that content about anti-substance use behaviors on Twitter is being offset by conflicting posts that are encouraging marijuana use and more effectively reaching a mass audience of young people. In response, we are diligently working to inform substance use prevention efforts about the volume and type of influential social media profiles that prevention efforts need to counter.

While there is certainly more work to be done, improving knowledge in this way is one step in the right direction to help prevention efforts better strategize how to debunk the false and risky social media posts that are connecting with young people. Likewise, it is of great importance to steer similar research pursuits towards the study of relevant mental and sexual health topics that extend beyond substance use prevention in order to safeguard the wellbeing of young people.

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This post is part of the March 2016 “Social Networks” series of the Institute for Public Health’s blog. Subscribe to email updates or follow us on Twitter and Facebook to receive notifications about our latest blog posts.