| Summary: | The public has always been concerned about the problem behaviors of children and teenagers (such as cigarette and alcohol use), especially among disadvantaged groups (e.g., left-behind children in China); in the current information era, left-behind children’s use of social media also has increasingly expanded, which has diverse effects on their adaptation. Accordingly, the present study examined the association between exposure to relevant content on social media and left-behind children’s tobacco and alcohol use, as well as the underlying mechanisms—the mediating effect of deviant peer affiliation and the moderating effect of parent–child contact, the gender differences were also investigated. A sample of 515 Chinese left-behind children (<i>M</i><sub>age</sub> = 13.39 ± 2.52 years, 45.0% girls) was recruited to complete a set of questionnaires assessing the main variables. The results show that social media exposure was positively associated with tobacco and alcohol use and that deviant peer affiliation significantly mediated this relationship. Furthermore, parent–child interaction attenuated the link between social media exposure and cigarette and alcohol use among left-behind girls, but this moderating effect was not statistically significant among left-behind boys. The moderating role of parent–child contact in the association between deviant peer affiliation and tobacco and alcohol use was insignificant in both boys and girls. These findings may have significance in several ways—theoretically, they not only deepen our understanding of the risk factors and mechanism of tobacco and alcohol use among left-behind children in the current information era and the influences of social media use; practically, they provide direction for the health improvement of left-behind children of different genders.
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