Objective:

To advance a conceptual framework that positions digital e-cigarette marketing as a critical digital health and platform governance challenge affecting youth health behaviors in Southeast Asia, emphasizing the urgency of addressing this issue.

Key Findings:

• Digital marketing of e-cigarettes operates through a platform-mediated ecosystem, influencing youth exposure and behavior, with significant implications for policy.
• Influencer-led promotion blurs the lines between commercial messaging and peer communication, increasing e-cigarette normalization among youth.
• Systematic reviews link exposure to e-cigarette advertising on digital platforms with increased susceptibility and intention to use among adolescents.

Interpretation:

The framework conceptualizes youth e-cigarette use as an outcome of interactions between platform design, social influence, digital access pathways, and regulatory environments, providing actionable insights for stakeholders.

Limitations:

• Evidence from Southeast Asia remains limited but is growing, which may affect the robustness of the framework.
• There is a structural gap between regulatory intent and real-world enforcement of e-cigarette marketing.

Conclusion:

The dynamics of digital marketing and youth exposure to e-cigarettes necessitate urgent attention for effective governance and health protection, calling for immediate action.