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Thepthien BO, Jayasvasti I, Ham E. The prevalence of kratom use and association with co-occurring substance use among adolescents: a 2022 Bangkok behavioral surveillance survey, Thailand. J Ethn Subst Abuse 2024:1-15. [PMID: 38900672 DOI: 10.1080/15332640.2024.2367233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Thailand removed kratom from the list of prohibited substances in 2021, possession and consumption of Kratom is now legal. It is prohibited from selling Kratom to anyone under the age of 18 and/or who is pregnant or breastfeeding. While there are benefits from kratom use with few reported adverse effects, escalating dose and increased use frequency raise the risk for toxic events in the setting of polysubstance use or development of a use disorder. We utilized data from the Behavior Surveillance Survey in Bangkok (n = 5,740) to examine the use of kratom with other substances use in the 12 months before the survey. The prevalence of past-year kratom use among students was 9.3% (95%CI = 8.7-9.9), with higher proportions of males (12.4 versus 6.1%, p < 0.001). The factors associated with past 12-month kratom use were academic performance (Medium GPA; AOR = 2.41, 95% CI = 1.76-3.29; Low GPA; AOR = 4.15, 95% CI = 2.94-5.87), close friend use substance (AOR = 1.94, 95% CI = 1.44-2.59), cannabis use (AOR = 6.84, 95% CI = 4.61-10.15), consumed alcohol (AOR = 2.32, 95% CI = 1.77-3.02), smoked conventional cigarettes (AOR = 4.20, 95% CI = 3.16-5.58), used e-cigarettes (AOR = 4.37, 95% CI = 3.30-5.79) used illicit opioids (AOR = 8.13, 95% CI = 4.35-15.18), and other illicit drug use (AOR = 9.15, 95% CI = 3.78-22.14). These findings may be useful for the initial targeting of efforts to reduce adolescent consumption of kratom. Future studies should examine the effect of regulatory policies or other Thai FDA-related policies use of illicit drugs and e-cigarettes on kratom use.
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Affiliation(s)
- Bang-On Thepthien
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
| | | | - Eunyoung Ham
- Faculty of Child Welfare, Namseoul University, Cheonan, Republic of Korea
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Zhang L, Qiu SS, Ao SH, Zhao X. Association between health-related social media use and E-cigarette use among current cigarette users: the roles of anti-tobacco messages and harm perception. BMC Public Health 2024; 24:1278. [PMID: 38730280 PMCID: PMC11084065 DOI: 10.1186/s12889-024-18756-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The popularity of e-cigarettes is on the rise among current cigarette users. Therefore, there are concerns about their health implications. This study examined the impact of health-related social media use on e-cigarette use among current cigarette users. It assesses the mediating influence of online anti-tobacco messages and the moderating role of the harm perception of e-cigarettes. METHODS This study was focused on 563 current cigarette users from the 2022 Health Information National Trends Survey (HINTS). Three tasks were performed: (1) assessing the direct and indirect impacts of health-related social media use on e-cigarette use among current cigarette users, (2) exploring the mediating role of exposure to online anti-tobacco messages, and (3) examining the moderating influence of e-cigarette harm perception on the path from anti-tobacco messages to e-cigarette use. RESULTS Health-related social media use was positively associated with current cigarette users' e-cigarette use directly (bp = 0.183, p < .01) and indirectly through exposure to online anti-tobacco messages (bp = 0.023, 95% CI: [0.001, 0.051]). Harm perception of e-cigarettes moderated the relationship between online exposure to anti-tobacco messages and e-cigarette use (bp=-0.467, p < .01). The relationship appeared weaker for individuals who perceived greater harm from e-cigarettes. CONCLUSIONS Health-related social media use positively correlates with e-cigarette use among current cigarette users through exposure to online anti-tobacco messages. The perceived harm of e-cigarettes moderates this indirect path. These findings have implications for public health interventions aimed at smoking cessation.
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Affiliation(s)
- Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Sha Sarah Qiu
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau, China.
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3
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Sun Y, Prabhu P, Li D, McIntosh S, Rahman I. Vaping: Public Health, Social Media, and Toxicity. Online J Public Health Inform 2024; 16:e53245. [PMID: 38602734 PMCID: PMC11046396 DOI: 10.2196/53245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/26/2023] [Accepted: 03/08/2024] [Indexed: 04/12/2024] Open
Abstract
This viewpoint aims to provide a comprehensive understanding of vaping from various perspectives that contribute to the invention, development, spread, and consequences of e-cigarette products and vaping. Our analysis showed that the specific characteristics of e-cigarette products as well as marketing strategies, especially social media marketing, fostered the spread of vaping and the subsequent effects on human health and toxicity. We analyzed the components of e-cigarette devices and e-liquids, including the latest variants whose impacts were often overlooked. The different forms of nicotine, including salts and freebase nicotine, tobacco-derived nicotine, tobacco-free nicotine, and cooling agents (WS3 and WS23), have brought more choices for vapers along with more ways for e-cigarette manufacturers to advertise false understandings and present a greater threat to vapers' health. Our work emphasized the products of brands that have gained significant influence recently, which are contributing to severe public health issues. On the other hand, we also discussed in detail the toxicity of e-liquid components and proposed a toxicity mechanism. We also noticed that nicotine and other chemicals in e-liquids promote each other's negative effects through the oxidative stress and inflammatory nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway, a mechanism leading to pulmonary symptoms and addiction. The impact of government regulations on the products themselves, including flavor bans or regulations, has been limited. Therefore, we proposed further interventions or harm reduction strategies from a public health perspective.
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Affiliation(s)
- Yehao Sun
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Prital Prabhu
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
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Ryan CG, Karran EL, Wallwork SB, Pate JW, O'Keeffe M, Fullen BM, Livadas N, Jones N, Toumbourou JW, Gilchrist P, Cameron PA, Fatoye F, Ravindran D, Lorimer Moseley G. We Are All in This Together-Whole of Community Pain Science Education Campaigns to Promote Better Management of Persistent Pain. THE JOURNAL OF PAIN 2024; 25:902-917. [PMID: 37918470 DOI: 10.1016/j.jpain.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Persistent pain is a major public health issue-estimated to affect a quarter of the world's population. Public understanding of persistent pain is based on outdated biomedical models, laden with misconceptions that are contrary to best evidence. This understanding is a barrier to effective pain management. Thus, there have been calls for public health-based interventions to address these misconceptions. Previous pain-focussed public education campaigns have targeted pain beliefs and behaviours that are thought to promote recovery, such as staying active. However, prevailing pain-related misconceptions render many of these approaches counter-intuitive, at best. Pain Science Education improves understanding of 'how pain works' and has been demonstrated to improve pain and disability outcomes. Extending Pain Science Education beyond the clinic to the wider community seems warranted. Learning from previous back pain-focussed and other public health educational campaigns could optimise the potential benefit of such a Pain Science Education campaign. Pain Science Education-grounded campaigns have been delivered in Australia and the UK and show promise, but robust evaluations are needed before any firm conclusions on their population impact can be made. Several challenges exist going forward. Not least is the need to ensure all stakeholders are involved in the development and implementation of Pain Science Education public messaging campaigns. Furthermore, it is crucial that campaigns are undertaken through a health equity lens, incorporating underrepresented communities to ensure that any intervention does not widen existing health inequalities associated with persistent pain. PERSPECTIVE: Public misconceptions about pain are a significant public health challenge and a viable intervention target to reduce the personal, social, and economic burden of persistent pain. Adaptation of Pain Science Education, which improves misconceptions in a clinical setting, into the public health setting seems a promising approach to explore.
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Affiliation(s)
- Cormac G Ryan
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - Emma L Karran
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Sarah B Wallwork
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Joshua W Pate
- Pain Education Team to Advance Learning (PETAL) Collaboration; Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Mary O'Keeffe
- Pain Education Team to Advance Learning (PETAL) Collaboration; Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia
| | - Brona M Fullen
- Pain Education Team to Advance Learning (PETAL) Collaboration; UCD School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
| | - Nick Livadas
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - Niki Jones
- Pain Education Team to Advance Learning (PETAL) Collaboration
| | - John W Toumbourou
- Pain Education Team to Advance Learning (PETAL) Collaboration; Deakin University, School of Psychology and Centre for Social and Early Emotional Development, Geelong, Australia
| | - Peter Gilchrist
- Pain Education Team to Advance Learning (PETAL) Collaboration; The University of Adelaide Rural Clinical School, Rural Generalist Program, South Australia
| | - Paul A Cameron
- Pain Education Team to Advance Learning (PETAL) Collaboration; Fife Health & Social Care Partnership, Scotland, UK; School of Medicine, Cardiff University, UK
| | - Francis Fatoye
- Pain Education Team to Advance Learning (PETAL) Collaboration; Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, UK; Lifestyle Disease Entity, North-West University, South Africa
| | - Deepak Ravindran
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Department of Pain Medicine, Royal Berkshire NHS Foundation Trust, UK
| | - G Lorimer Moseley
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
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Wang L, Siau CS, Baharom N, Hairol MI, Huang L, Wee LH. Media Search Frequency, Source Credibility About e-Cigarette Health Information, and Motivation to Quit EC Among University Students in Chengdu, China. Int J Gen Med 2024; 17:895-907. [PMID: 38476623 PMCID: PMC10929557 DOI: 10.2147/ijgm.s430997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose E-cigarettes (ECs) are gaining popularity among young people. This study aimed to assess university student vapers' search frequency and source credibility of commonly used media in China, and their association with daily EC users' motivation to quit EC use. Participants and Methods This was a cross-sectional study involving an online quantitative survey in six universities in Chengdu, China. Participants answered questions on their EC use patterns, motivation to quit EC, use frequency and source credibility of media use. Hierarchical linear regression analyses were performed to determine the association between media search frequency and source credibility concerning EC health information with the motivation to quit EC. Results There were a total of 325 participants (Mean age = 20.43, SD = 1.333). Video platforms and social media were ranked frequently used by the participants and were deemed to be more trustworthy. Perceived trustworthiness of online media was the most influential predictor of motivation to quit EC. Those who reported a higher frequency of accessing video platforms and medical health applications recorded higher motivation to quit EC use. Source credibility of news portals were associated higher motivation to quit EC. The association between higher nicotine dependence and lower motivation to quit EC was attenuated when media source credibility and trustworthiness of online media were added into the fully adjusted regression models. Conclusion There is an association between media use frequency and source credibility to search for EC health information and motivation to quit vaping. More studies could be conducted to examine the effects of media use content on perceptions towards vaping and their motivation to quit vaping.
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Affiliation(s)
- Li Wang
- Ya’an Polytechnic College, Ya’an, Sichuan, 625000, People’s Republic of China
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Nizam Baharom
- Primer Healthcare Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, 71800, Malaysia
| | - Mohd Izzuddin Hairol
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Lixin Huang
- Chengdu Sport University, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Lei Hum Wee
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, 47500, Malaysia
- Non-Communicable Diseases and Public Health Research Group, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, 47500, Malaysia
- Digital Health and Innovations Impact Lab, Taylor’s University, Subang Jaya, 47500, Malaysia
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Liao LL, Chang LC, Lai IJ, Lee CK. College Students' E-health Literacy, Social Media Use, and Perceptions of E-cigarettes in Taiwan. J Community Health 2024; 49:52-60. [PMID: 37420015 DOI: 10.1007/s10900-023-01255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
This study aimed to examine the relationship between social media use, e-health literacy, and the risk and benefit perceptions of e-cigarettes among college students in Taiwan. A cross-sectional online survey was conducted with 1,571 Taiwanese college students, which included four questionnaires to assess participants' perceptions, social media use behavior, e-health literacy, and sociodemographic factors. The data were presented in terms of means, standard deviations, and percentages. Stepwise regression was used to identify factors associated with the participants' perceptions. The study found that 75.01% of the participants were exposed to e-cigarette information on social media, with 31.26% actively searching for it and 15.95% sharing it. Participants had a high e-cigarette risk perception, indicating low benefit perception, but acceptable e-health literacy. Factors such as current e-cigarette and tobacco use, e-health literacy, academic achievement, and sex significantly predicted e-cigarette risk perception, while sharing e-cigarette related information, sex, age, academic achievement, and current e-cigarette use significantly predicted its benefit perception. Thus, implementing effective e-health literacy programs to enhance college students' e-cigarette risk perception is recommended along with a proactive approach to tackle e-cigarette advertising messages on social media, minimizing their sharing behavior to decrease their perception of associated benefits.
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Affiliation(s)
- Li-Ling Liao
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Chun Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - I-Ju Lai
- Department of Nutrition, I-Shou University, Kaohsiung, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 70101, Taiwan.
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Zhang L, Harris Ao S, Francis Ye J, Zhao X. How does health communication on social media influence e-cigarette perception and use? A trend analysis from 2017 to 2020. Addict Behav 2024; 149:107875. [PMID: 37820562 DOI: 10.1016/j.addbeh.2023.107875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE E-cigarettes have achieved a high prevalence rapidly. While social media is among the most influential platforms for health communication, its impact on attitudes and behaviors of e-cigarettes and its changes over time remain underexplored. This study aims to address the gap. METHODS Four years of data (2017-2020) were derived from the U.S. Health Information National Trends Survey (HINTS) (aged 18-64 years, n = 9,914). Initially, key variables were compared across years. Furthermore, guided by the health belief model, we employed a moderated mediation model to examine the influence of social media health communication on the public's perceptions and behaviors related to e-cigarettes, distinguishing between smokers and non-smokers throughout the four-year period. RESULTS The evidence shows a process of dynamic interaction between communication, perception, and behavior. (1) We observed an increasing trend of social media health communication (SMH) and perceived relative harm of e-cigarettes (PHE). (2) Higher SMH was associated with more e-cigarette use directly in 2019. (3) Higher SMH was associated with less e-cigarette use indirectly through PHE in 2020. (4) Smokers consistently displayed heightened sensitivity in responding to harm perception compared to non-smokers. CONCLUSIONS The findings support two mechanisms underlying the association between SMH and e-cigarette use: direct and indirect. The changes in the pathways during the timespan may have been influenced by increased e-cigarette information on social media and public health events like COVID-19. Stricter regulations for unverified e-cigarette advertisements and anti-e-cigarette education on social media are called for to curtail e-cigarette use.
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Affiliation(s)
- Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau
| | - Jizhou Francis Ye
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau.
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8
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Chacon L, Mitchell G, Golder S. The commercial promotion of electronic cigarettes on social media and its influence on positive perceptions of vaping and vaping behaviours in Anglophone countries: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002736. [PMID: 38232105 DOI: 10.1371/journal.pgph.0002736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024]
Abstract
There is ongoing scientific and policy debate about the role e-cigarettes play in tobacco control, with concerns centring around unknown long-term effects, and the potential industry co-option of harm reduction efforts, including marketing to youths. There is substantial evidence of the influence of conventional cigarette promotion on smoking behaviours in Anglophone countries, and the popularity of social networking sites, as well as the lack of marketing regulations on the commercial promotion of electronic cigarettes online, suggest an urgent need to explore this topic further. This scoping review aims to map the existing evidence related to the influence of e-cigarette commercial promotion on social media on positive perceptions of vaping and vaping behaviours in core Anglophone countries. Searches were conducted in CENTRAL, Cochrane Database of Systematic Reviews (CDSR), Embase, Epistemonikos, MEDLINE, PsycINFO and Science Citation Index, on the 21st of July 2022. From 1,385 studies, 11 articles were included in the final review, using diverse study designs, including focus groups, content analysis, cross-sectional studies, and experiments. The studies were primarily based in the U.S. and evidenced the association between the commercial promotion of e-cigarettes on social media with positive perceptions of vaping and vaping behaviours, particularly among young people, addressing diverse themes including celebrities' sponsorship, e-liquid appeal (including flavours and nicotine levels), users' engagement with ads, and other marketing strategies. Further, social networking sites commercially promoting e-cigarettes might increase positive attitudes towards vaping and vaping behaviours, particularly among youths. Future research should be conducted in broader settings, incorporate larger and diverse sample sizes, ensure research transparency, cover multiple social networking sites, emphasize ecological validity, and foment longitudinal studies.
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Affiliation(s)
- L Chacon
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | - G Mitchell
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | - S Golder
- Department of Health Sciences, University of York, Heslington, United Kingdom
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9
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Zhou Y, Kwon M, Park E, Chang YP. What Can Customers See? Exposed Information on E-Cigarette Online Retail Website: A Systematic Review. J Addict Nurs 2023; 34:251-265. [PMID: 38015576 DOI: 10.1097/jan.0000000000000548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND The internet is the main channel for electronic nicotine delivery systems sales that the media uses to publicize electronic cigarettes (e-cigarettes). Once e-cigarettes entered the market, they quickly became widely available online and in retail stores in many countries and regions around the world. This systematic review aims to explore the online marketing strategies for e-cigarette retail websites including the design of e-cigarette retail websites and how the information of retail websites was exposed to the public. METHOD Studies were searched in five databases: Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science, Communication & Mass Media Complete, and PubMed. Included studies were published between 2007 and 2019. RESULTS Eight studies were included in this review. Topics covered included smoking cessation claims, nicotine content claims, health or harmful substance exposure claims, age restriction/verification, membership and discounts, and media and celebrity effect. Most of the claims included information about the benefits of e-cigarettes, such as helping to quit smoking, being more environmentally friendly than traditional paper cigarettes, and not containing nicotine. Common marketing techniques included celebrity endorsements, showing discounts or membership offers, or getting a link to buy from the media. CONCLUSIONS The marketing of e-cigarettes is complex, and the authenticity of the information presented on the websites needs to be thoroughly understood. Such information will undoubtedly increase the interest and desire of potential buyers for e-cigarettes. Therefore, it is critical to establish necessary regulations regarding e-cigarette product information.
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Affiliation(s)
- Yanjun Zhou
- Yanjun Zhou, BSN, Misol Kwon, BS, RN, Eunhee Park, PhD, RN, APHN-BC, and Yu-Ping Chang, PhD, RN, FGSA, FIAAN, FAAN, School of Nursing, University at Buffalo, New York
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10
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Dobbs PD, Boykin AA, Ezike N, Myers AJ, Colditz JB, Primack BA. Twitter Sentiment About the US Federal Tobacco 21 Law: Mixed Methods Analysis. JMIR Form Res 2023; 7:e50346. [PMID: 37651169 PMCID: PMC10502593 DOI: 10.2196/50346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND On December 20, 2019, the US "Tobacco 21" law raised the minimum legal sales age of tobacco products to 21 years. Initial research suggests that misinformation about Tobacco 21 circulated via news sources on Twitter and that sentiment about the law was associated with particular types of tobacco products and included discussions about other age-related behaviors. However, underlying themes about this sentiment as well as temporal trends leading up to enactment of the law have not been explored. OBJECTIVE This study sought to examine (1) sentiment (pro-, anti-, and neutral policy) about Tobacco 21 on Twitter and (2) volume patterns (number of tweets) of Twitter discussions leading up to the enactment of the federal law. METHODS We collected tweets related to Tobacco 21 posted between September 4, 2019, and December 31, 2019. A 2% subsample of tweets (4628/231,447) was annotated by 2 experienced, trained coders for policy-related information and sentiment. To do this, a codebook was developed using an inductive procedure that outlined the operational definitions and examples for the human coders to annotate sentiment (pro-, anti-, and neutral policy). Following the annotation of the data, the researchers used a thematic analysis to determine emergent themes per sentiment category. The data were then annotated again to capture frequencies of emergent themes. Concurrently, we examined trends in the volume of Tobacco 21-related tweets (weekly rhythms and total number of tweets over the time data were collected) and analyzed the qualitative discussions occurring at those peak times. RESULTS The most prevalent category of tweets related to Tobacco 21 was neutral policy (514/1113, 46.2%), followed by antipolicy (432/1113, 38.8%); 167 of 1113 (15%) were propolicy or supportive of the law. Key themes identified among neutral tweets were news reports and discussion of political figures, parties, or government involvement in general. Most discussions were generated from news sources and surfaced in the final days before enactment. Tweets opposing Tobacco 21 mentioned that the law was unfair to young audiences who were addicted to nicotine and were skeptical of the law's efficacy and importance. Methods used to evade the law were found to be represented in both neutral and antipolicy tweets. Propolicy tweets focused on the protection of youth and described the law as a sensible regulatory approach rather than a complete ban of all products or flavored products. Four spikes in daily volume were noted, 2 of which corresponded with political speeches and 2 with the preparation and passage of the legislation. CONCLUSIONS Understanding themes of public sentiment-as well as when Twitter activity is most active-will help public health professionals to optimize health promotion activities to increase community readiness and respond to enforcement needs including education for retailers and the general public.
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Affiliation(s)
- Page D Dobbs
- Health, Human Performance and Recreation Department, University of Arkansas, Fayetteville, AR, United States
| | - Allison Ames Boykin
- Education Statistics and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Nnamdi Ezike
- Education Statistics and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Aaron J Myers
- Education Statistics and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Jason B Colditz
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Brian A Primack
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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11
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Rohde JA, Liu J, Rees VW. Community and Opinion Leadership Effects on Vaping Discourse: A Network Analysis of Online Reddit Threads. JOURNAL OF HEALTH COMMUNICATION 2023; 28:487-497. [PMID: 37341521 PMCID: PMC11323707 DOI: 10.1080/10810730.2023.2225447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Reddit is a popular hub for discussing vaping. A deeper understanding of the factors that influence this online discourse could inform public health messaging efforts targeting this platform. Using a network analysis framework, we sought to investigate the role of opinion leaders and online communities in facilitating vaping discussions on Reddit. We collected Reddit submissions about vaping posted in May 2021 and used these submissions to generate subreddit-level (N=261) and thread-level (N=8,377) data sets. We coded subreddits into four community categories: 1) Vaping, 2) Substance use, 3) Cessation, and 4) Non-specific. We used sociometric in-degree centrality statistics to identify subreddit opinion leaders. We computed non-parametric ANOVAs and negative binomial regressions to test associations between opinion leadership and subreddit community category variables on subreddit network composition (comprised of subreddit-level network nodes and edges) and the number of commenters on Reddit threads about vaping (thread-level). Subreddit network composition was largely dependent on opinion leaders in Non-specific communities, and less so in Vaping and Substance use communities. At the thread-level, the rate of commenters was higher among threads initiated by opinion leaders than non-opinion leaders (adjusted rate ratio [aRR]=4.84). Furthermore, threads posted in Vaping (aRR=1.64), Substance use (aRR=1.92), and Cessation (aRR=1.21) communities had higher commenter rates than those posted in Non-specific communities. Communities and opinion leaders play a key role in the composition and reach of vaping discussions on Reddit. These findings provide a foundation for public health campaigns and interventions targeting Reddit and perhaps other social media platforms.
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Affiliation(s)
- Jacob A Rohde
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jessica Liu
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Vaughan W Rees
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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12
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Xie Z, Lee S, Xu E, Li D. Public Perceptions and Discussions of Premium Cigars on Reddit. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.22.23291751. [PMID: 37425876 PMCID: PMC10327260 DOI: 10.1101/2023.06.22.23291751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Introduction While premium cigars have similar addictive, toxic, and carcinogenic constituents as other cigars and cigarettes, about 1% of the US adults reported premium cigar use from 2010 to 2019. This study aimed to understand public perceptions and discussions of premium cigars on Reddit, one of the most popular social media platforms. Methods Using keywords such as "premium cigar", we extracted 2,238 Reddit posts from Reddit Archive between July 2019 and June 2021. Among them, 1,626 posts were related to premium cigars. By employing the inductive approach, we manually coded each Reddit post on premium cigars to understand public perceptions and discussions of premium cigars by summarizing them into different topics and subtopics. Results Longitudinal analysis showed that the number of Reddit posts on premium cigars increased since June 2020. Content analysis showed that among Reddit posts related to premium cigars, the most popular topic is "Information sharing" (75.72%), in which Reddit users shared their perceptions about premium cigars, asked for advice, and provided some recommendations about premium cigars. Over one-quarter of posts (27.17%) are sharing user experiences of premium cigars (such as taste). Nearly one-fifth (18.99%) of posts are discussing the affordability of premium cigars. In addition, 7.87% of posts are discussing legal/policy issues related to premium cigars, and 6.82% of posts are related to the health risks of premium cigars compared to cigarettes. Conclusions Public perceptions including misperceptions, user experiences, and affordability related to premium cigars have been actively discussed on Reddit.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Sarah Lee
- Goergen Institute for Data Science, University of Rochester, Rochester, New York, USA
| | - Emily Xu
- Goergen Institute for Data Science, University of Rochester, Rochester, New York, USA
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, USA
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13
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Zheng X, Lin HC. How Does Online e-cigarette Advertisement Promote Youth's e-cigarettes Use? The Mediating Roles of Social Norm and Risk Perceptions. HEALTH COMMUNICATION 2023; 38:1388-1394. [PMID: 34872415 DOI: 10.1080/10410236.2021.2010350] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The adoption of the internet, social media, and e-cigarettes are on the rise among U.S. youth. Uses of social media and online platforms increase the probability for youth to encounter e-cigarette advertisements. Departing from this line of reasoning, we examine the underlying mechanisms of how online e-cigarettes exposure promotes youth's e-cigarette use. Drawing on insights from the social construction of risk model, this study looks at how perceived social norms and risk perception mediate the link between online e-cigarette advertisement exposure and e-cigarette use. Youth aged 12-17 from the Public Assessment of Tobacco and Health (PATH) Study Waves 2-4 (2014-2018) were included (N = 6,067). Controlling for demographic and other known risk factors for e-cigarette use, respondents who had been exposed to online e-cigarette ads at Wave 2 perceived higher levels of positive social norms of e-cigarette use at Wave 3 (β = 0.13, p < .001) which was associated with lower e-cigarette risk perception at Wave 3 (β = -0.22, p < .001). Lower e-cigarette risk perception at Wave 3 resulted in a higher likelihood of e-cigarette use at Wave 4 (AOR = 0.51, p < .001). Online e-cigarettes ads exposure at Wave 2 predicted e-cigarette use at Wave 4 (AOR = 1.87, p < .001). The results indicate that norm perception associated with online e-cigarettes ads may twist youth's e-cigarette risk perception that is associated with subsequent usage. Interventions to curb youth's e-cigarette use can target social norms of e-cigarette use and restrict e-cigarette advertisement exposure to youth.
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Affiliation(s)
- Xia Zheng
- The Media School, Indiana University at Bloomington
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14
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Lee J, Suttiratana SC, Sen I, Kong G. E-Cigarette Marketing on Social Media: A Scoping Review. CURRENT ADDICTION REPORTS 2023. [DOI: 10.1007/s40429-022-00463-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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15
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Leung T, Kasson E, Singh AK, Ren Y, Kaiser N, Huang M, Cavazos-Rehg PA. Topics and Sentiment Surrounding Vaping on Twitter and Reddit During the 2019 e-Cigarette and Vaping Use-Associated Lung Injury Outbreak: Comparative Study. J Med Internet Res 2022; 24:e39460. [PMID: 36512403 PMCID: PMC9795395 DOI: 10.2196/39460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/16/2022] [Accepted: 10/29/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. OBJECTIVE This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) to explore the context surrounding vaping during the 2019 EVALI outbreak and to support the feasibility of using data from both social platforms to develop in-depth and intelligent vaping detection models on social media. METHODS Data were extracted from both Twitter (316,620 tweets) and Reddit (17,320 posts) from July 2019 to September 2019 at the peak of the EVALI crisis. High-throughput computational analyses (sentiment analysis and topic analysis) were conducted. In addition, in-depth manual content analyses were performed and compared with computational analyses of content on both platforms (577 tweets and 613 posts). RESULTS Vaping-related posts and unique users on Twitter and Reddit increased from July 2019 to September 2019, with the average post per user increasing from 1.68 to 1.81 on Twitter and 1.19 to 1.21 on Reddit. Computational analyses found the number of positive sentiment posts to be higher on Reddit (P<.001, 95% CI 0.4305-0.4475) and the number of negative posts to be higher on Twitter (P<.001, 95% CI -0.4289 to -0.4111). These results were consistent with the clinical content analyses results indicating that negative sentiment posts were higher on Twitter (273/577, 47.3%) than Reddit (184/613, 30%). Furthermore, topics prevalent on both platforms by keywords and based on manual post reviews included mentions of youth, marketing or regulation, marijuana, and interest in quitting. CONCLUSIONS Post content and trending topics overlapped on both Twitter and Reddit during the EVALI period in 2019. However, crucial differences in user type and content keywords were also found, including more frequent mentions of health-related keywords on Twitter and more negative health outcomes from vaping mentioned on both Reddit and Twitter. Use of both computational and clinical content analyses is critical to not only identify signals of public health trends among vaping-related social media content but also to provide context for vaping risks and behaviors. By leveraging the strengths of both Twitter and Reddit as publicly available data sources, this research may provide technical and clinical insights to inform automatic detection of social media users who are vaping and may benefit from digital intervention and proactive outreach strategies on these platforms.
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Affiliation(s)
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Avineet Kumar Singh
- Department of Integrated Information Technology, University of South Carolina, Columbia, SC, United States
| | - Yang Ren
- Department of Integrated Information Technology, University of South Carolina, Columbia, SC, United States
| | - Nina Kaiser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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16
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Lee J, Terashima JP, Parker MA. The association between E-cigarette use and Kratom use among US adults. Prev Med 2022; 164:107295. [PMID: 36208816 DOI: 10.1016/j.ypmed.2022.107295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/22/2022] [Accepted: 10/02/2022] [Indexed: 10/31/2022]
Abstract
Kratom, an herbal substance with stimulant and opioid-like effects commonly used in capsules or powder to be ingested or brewed as a tea, has been gaining popularity in the United States (US). US e-cigarette use (i.e., vaping) has exponentially increased in recent years. Given the potential risks of kratom (e.g., poisonings) and the increasing prevalence of e-cigarette use, understanding the association between them is important to inform prevention strategies and regulatory policies. We harnessed data from the 2020 National Survey on Drug Use and Health (NSDUH; n = 27,170) to examine past-year kratom use by past-year e-cigarette use among adults. We ran a logistic regression model on kratom use by e-cigarette use adjusting for associated factors with substance use. Among all respondents, the estimated prevalence of past-year kratom use was 0.9% and an estimated 9.7% reported past-year e-cigarette use. Our multivariable model found those with e-cigarette use (vs. not) had 4.80 higher odds of using kratom in the past year (aOR = 4.80; 95% CI = 2.62, 8.80). These findings might help inform the need for continuing education for physicians and healthcare providers related to practice in managing patients with kratom use, future studies for regulatory policies on e-cigarettes (e.g., e-liquids), or other FDA policies related to kratom.
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Affiliation(s)
- Juhan Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, United States of America.
| | - Javier Ponce Terashima
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, United States of America
| | - Maria A Parker
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN 47401, United States of America
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17
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Perceptions and Use of Electronic Cigarettes Among Young Adults in Vietnam 2020. J Community Health 2022; 47:822-827. [PMID: 35764721 DOI: 10.1007/s10900-022-01113-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 10/17/2022]
Abstract
Electronic cigarette use among adolescents has increased in the past decade. Little is known about the perception and use of e-cigarettes in Vietnam, especially among young people. This study examines the perceptions and use of electronic cigarettes among young adults in Vietnam. The study uses data from a survey of adult tobacco consumption among adults at the provincial level in 2020, which was funded and managed by the Vietnam Tobacco Control Fund-Ministry of Health. Data were collected from 34 provinces and cities throughout Vietnam and managed using REDCap software. The survey engaged 80,166 participants, of which 9478 were young adults aged 15-24 were selected and reported in this paper. The results show that, at the time of the survey, 2.4% of young Vietnamese adults were smoking e-cigarettes. Many survey participants cited more than one reason for smoking e-cigarettes. These reasons included preferring the taste of e-cigarettes (64.0%), disliking the odour of other cigarettes (46.2%), following the example of family members (44.9%), and believing e-cigarettes threatened fewer health risks (39.1%). Almost half of the e-cigarette users wanted to quit (48%). E-cigarette use was associated with males living in urban areas who are aware of the Law on Prevention and Control of Tobacco Harms. The findings of this study provide evidential data that support public health policies aimed at reducing and ceasing e-cigarette use among young people.
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18
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Silver N, Kucherlapaty P, Kostygina G, Tran H, Feng M, Emery S, Schillo B. Discussions of Flavored ENDS Sales Restrictions: Themes Related to Circumventing Policies on Reddit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7668. [PMID: 35805325 PMCID: PMC9266029 DOI: 10.3390/ijerph19137668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To examine conversations among JUUL users on Reddit related to restrictions on flavored ENDS and the shifting policy landscape. METHODS Posts and comments (n = 166,169) between May 2019 and May 2020 on the subreddit r/JUUL were scraped using pushshift.io API. Keyword filters were used to identify texts discussing flavored ENDS products (n = 33,884 texts). These were further narrowed down to texts discussing flavor policy workaround strategies (n = 7429) and N-gram analysis was performed. Finally, findings from the N-gram analysis were triangulated through qualitative review of a separate sample of texts (n = 488) from the flavor policy-related posts and comments. RESULTS Overall activity on the subreddit r/JUUL peaked around the time of the EVALI outbreak (September 2019) and when FDA issued guidance restricting flavored ENDS product sales (January 2020). The N-gram analysis revealed an active discussion of banned products one can "still get" or "JUUL compatible" alternatives, including specific brands, brick and mortar locations, and specific flavors. Ten dominant themes emerged from the qualitative review, with some posts containing more than one theme. CONCLUSION Many users turned to Reddit for information related to the shifting regulatory landscape concerning flavored ENDS. Discussions focused on both legal alternatives to banned products as well as illegal means of acquiring JUUL pods, including residual retail supply, online, and mail vendors.
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Affiliation(s)
- Nathan Silver
- Truth Initiative Schroeder Institute, Washington, DC 20001, USA; (P.K.); (B.S.)
| | | | - Ganna Kostygina
- NORC at the University of Chicago, Chicago, IL 60603, USA; (G.K.); (H.T.); (M.F.); (S.E.)
| | - Hy Tran
- NORC at the University of Chicago, Chicago, IL 60603, USA; (G.K.); (H.T.); (M.F.); (S.E.)
| | - Miao Feng
- NORC at the University of Chicago, Chicago, IL 60603, USA; (G.K.); (H.T.); (M.F.); (S.E.)
| | - Sherry Emery
- NORC at the University of Chicago, Chicago, IL 60603, USA; (G.K.); (H.T.); (M.F.); (S.E.)
| | - Barbara Schillo
- Truth Initiative Schroeder Institute, Washington, DC 20001, USA; (P.K.); (B.S.)
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19
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Silver N, Kierstead E, Kostygina G, Tran H, Briggs J, Emery S, Schillo B. The influence of pro-vaping “gatewatchers” on the dissemination of COVID-19 misinformation on Twitter (Preprint). J Med Internet Res 2022; 24:e40331. [PMID: 36070451 PMCID: PMC9506503 DOI: 10.2196/40331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Nathan Silver
- Schroeder Institute, Truth Initiative, Washington, DC, United States
| | - Elexis Kierstead
- Schroeder Institute, Truth Initiative, Washington, DC, United States
| | - Ganna Kostygina
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, United States
| | - Hy Tran
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, United States
| | - Jodie Briggs
- Schroeder Institute, Truth Initiative, Washington, DC, United States
| | - Sherry Emery
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, United States
| | - Barbara Schillo
- Schroeder Institute, Truth Initiative, Washington, DC, United States
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20
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Koo EY, Jin V, Weinreich HM, Wenig BL. Otolaryngology Resident Education and Perceptions of e-cigarettes. Ann Otol Rhinol Laryngol 2022; 131:622-628. [PMID: 34365835 PMCID: PMC10066855 DOI: 10.1177/00034894211037415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To date, there are no reports of otolaryngology residents' knowledge and confidence in discussing e-cigarette use. The purpose of this study was to evaluate otolaryngology resident e-cigarette knowledge and confidence in counseling patients on e-cigarette use. STUDY DESIGN Cross-sectional national survey. SETTING Accreditation Council for Graduate Medical Education otolaryngology residents in the United States. METHODS US otolaryngology residents were distributed surveys electronically in September 2020. RESULTS A total of 150 participants replied for a response rate of 8.88%. The majority, 93.10% have not received formal education on e-cigarettes during their residency training. The most common resource of e-cigarette information overall was social media (78.46%). Within academia, the most common resources of e-cigarette education were patient interactions (63.16%) and colleagues (54.74%). Patients commonly inquire residents about e-cigarettes for smoking cessation (85.07%) and their long-term health effects (83.58%). Almost 67% of residents rarely or never ask patients about e-cigarette use. Only 4.35% of residents are not confident discussing traditional cigarette use, while 58.70% are not confident discussing e-cigarettes. CONCLUSION Otolaryngology residents have not received formal education in e-cigarettes and are not confident discussing e-cigarettes with their patients. This highlights the need for e-cigarette education during otolaryngology residency to improve patient e-cigarette counseling.
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Affiliation(s)
- Elliot Y Koo
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Vivian Jin
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Heather M Weinreich
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Barry L Wenig
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
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21
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Silver NA, Kierstead EC, Briggs J, Schillo B. Charming e-cigarette users with distorted science: a survey examining social media platform use, nicotine-related misinformation and attitudes towards the tobacco industry. BMJ Open 2022; 12:e057027. [PMID: 35649587 PMCID: PMC9160585 DOI: 10.1136/bmjopen-2021-057027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/15/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To examine the role of social media in promoting recall and belief of distorted science about nicotine and COVID-19 and whether recall and belief predict tobacco industry beliefs. DESIGN Young adults aged 18-34 years (N=1225) were surveyed cross-sectionally via online Qualtrics panel. The survey assessed recall and belief in three claims about nicotine and COVID-19 and three about nicotine in general followed by assessments of industry beliefs and use of social media. Ordinal logistic regression with robust standard errors controlling for gender, race/ethnicity, education, current e-cigarette use and age was used to examine relationships between variables. RESULTS Twitter use was associated with higher odds of recall (OR=1.21, 95% CI=1.01 to 1.44) and belief (OR=1.26, 95% CI=1.04 to 1.52) in COVID-19-specific distorted science. YouTube use was associated with higher odds of believing COVID-19-specific distorted science (OR=1.32, 95% CI=1.09 to 1.60). Reddit use was associated with lower odds of believing COVID-19-specific distorted science (OR=0.72, 95% CI=0.59 to 0.88). Recall (OR=1.26, 95% CI=1.07 to 1.47) and belief (OR=1.28, 95% CI=1.09 to 1.50) in distorted science about nicotine in general as well as belief in distorted science specific to COVID-19 (OR=1.61, 95% CI=1.34 to 1.95) were associated with more positive beliefs about the tobacco industry. Belief in distorted science about nicotine in general was also associated with more negative beliefs about the tobacco industry (OR=1.18, 95% CI=1.02 to 1.35). CONCLUSIONS Use of social media platforms may help to both spread and dispel distorted science about nicotine. Addressing distorted science about nicotine is important, as it appears to be associated with more favourable views of the tobacco industry which may erode public support for effective regulation.
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Affiliation(s)
- Nathan A Silver
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
| | - Elexis C Kierstead
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
| | - Jodie Briggs
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
| | - Barbara Schillo
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
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22
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Barrientos-Gutierrez I, Gallegos-Carrillo K, Cruz-Jimenez L, Rodriguez-Bolaños R, Arillo-Santillán E, Thrasher JF. Exposure to e-cigarette advertising and provaping websites, and the social acceptability of their use among nicotine users. Rev Panam Salud Publica 2022; 46:e87. [PMID: 36211245 PMCID: PMC9534350 DOI: 10.26633/rpsp.2022.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate the prevalence of exposure to Internet communications on and advertising of electronic cigarettes (e-cigarettes) and their association with perceptions of the social acceptability of e-cigarettes in Mexico. Methods Data were analyzed from eight surveys (2018-2021) of an online sample of Mexican adult (> 18 years) smokers and dual users (of combustible and electronic cigarettes). Self-reported exposure to e-cigarette advertising across various marketing channels was assessed, as well as visits to e-cigarette websites. Logistic regression analysis was used to evaluate the association between perceptions of the social acceptability of e-cigarette use and level of advertising exposure and visits to e-cigarette websites. Results The Internet and outside e-cigarette stores were where exposure to advertising most occurred, as reported by 47.4% and 46.8% of respondents, respectively. Respondents who noticed e-cigarette advertisements on the Internet (adjusted odds ratio (OR) 1.43, 95% confidence intervals (CI) 1.25, 1.63), outside e-cigarette stores (adjusted OR 1.31, 95% CI 1.14, 1.50), and in temporary outlets (adjusted OR 1.16, 95% CI 1.01, 1.34), and those who visited e-cigarette websites (adjusted OR 1.48, 95% CI 1.25, 1.76) were more likely to perceive e-cigarettes as socially acceptable. Noticing advertisements across more channels was also associated with higher perceived social acceptability of e-cigarette use. Conclusions Being exposed to e-cigarette marketing, either online or through traditional marketing channels, is associated with perceived social acceptability of e-cigarette use, as is contact with provaping sites. Regulatory options to avoid the proliferation of promotional websites disguised as opinion or user sites need to be considered.
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Affiliation(s)
- Inti Barrientos-Gutierrez
- Center for Evaluation and Survey ResearchMexican National Institute of Public HealthCuernavacaMexicoCenter for Evaluation and Survey Research, Mexican National Institute of Public Health, Cuernavaca, Mexico.
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research UnitMexican Institute of Social SecurityCuernavacaMexicoEpidemiology and Health Services Research Unit, Mexican Institute of Social Security, Cuernavaca, Mexico.
| | - Lizeth Cruz-Jimenez
- Center for Evaluation and Survey ResearchMexican National Institute of Public HealthCuernavacaMexicoCenter for Evaluation and Survey Research, Mexican National Institute of Public Health, Cuernavaca, Mexico.
| | - Rosibel Rodriguez-Bolaños
- Population Health Research CenterMexican National Institute of Public HealthCuernavacaMexicoPopulation Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Mexico.
| | - Edna Arillo-Santillán
- Population Health Research CenterMexican National Institute of Public HealthCuernavacaMexicoPopulation Health Research Center, Mexican National Institute of Public Health, Cuernavaca, Mexico.
| | - James F. Thrasher
- Arnold School of Public HealthUniversity of South CarolinaColumbia, SCUnited States of AmericaArnold School of Public Health, University of South Carolina, Columbia, SC, United States of America.
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23
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Purushothaman V, McMann T, Nali M, Li Z, Cuomo R, Mackey TK. Content Analysis of Nicotine Poisoning (Nic Sick) Videos on TikTok: Retrospective Observational Infodemiology Study. J Med Internet Res 2022; 24:e34050. [PMID: 35353056 PMCID: PMC9008518 DOI: 10.2196/34050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 12/24/2022] Open
Abstract
Background TikTok is a microvideo social media platform currently experiencing rapid growth and with 60% of its monthly users between the ages of 16 and 24 years. Increased exposure to e-cigarette content on social media may influence patterns of use, including the risk of overconsumption and possible nicotine poisoning, when users engage in trending challenges online. However, there is limited research assessing the characteristics of nicotine poisoning–related content posted on social media. Objective We aimed to assess the characteristics of content on TikTok that is associated with a popular nicotine poisoning–related hashtag. Methods We collected TikTok posts associated with the hashtag #nicsick, using a Python programming package (Selenium) and used an inductive coding approach to analyze video content and characteristics of interest. Videos were manually annotated to generate a codebook of the nicotine sickness–related themes. Statistical analysis was used to compare user engagement characteristics and video length in content with and without active nicotine sickness TikTok topics. Results A total of 132 TikTok videos associated with the hashtag #nicsick were manually coded, with 52.3% (69/132) identified as discussing firsthand and secondhand reports of suspected nicotine poisoning symptoms and experiences. More than one-third of nicotine poisoning–related content (26/69, 37.68%) portrayed active vaping by users, which included content with vaping behavior such as vaping tricks and overconsumption, and 43% (30/69) of recorded users self-reported experiencing nicotine sickness, poisoning, or adverse events such as vomiting following nicotine consumption. The average follower count of users posting content related to nicotine sickness was significantly higher than that for users posting content unrelated to nicotine sickness (W=2350.5, P=.03). Conclusions TikTok users openly discuss experiences, both firsthand and secondhand, with nicotine adverse events via the #nicsick hashtag including reports of overconsumption resulting in sickness. These study results suggest that there is a need to assess the utility of digital surveillance on emerging social media platforms for vaping adverse events, particularly on sites popular among youth and young adults. As vaping product use-patterns continue to evolve, digital adverse event detection likely represents an important tool to supplement traditional methods of public health surveillance (such as poison control center prevalence numbers).
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Affiliation(s)
- Vidya Purushothaman
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anesthesiology and Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
| | - Tiana McMann
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anthropology, University of California San Diego, La Jolla, CA, United States.,S-3 Research, San Diego, CA, United States
| | - Matthew Nali
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anesthesiology and Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States.,S-3 Research, San Diego, CA, United States
| | - Zhuoran Li
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anthropology, University of California San Diego, La Jolla, CA, United States.,S-3 Research, San Diego, CA, United States
| | - Raphael Cuomo
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anesthesiology and Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, United States
| | - Tim K Mackey
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anthropology, University of California San Diego, La Jolla, CA, United States.,S-3 Research, San Diego, CA, United States
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Sæbø G, Lund I. Public support for further regulating smoking, snus and e-cigarettes in Norway, and its associations with risk perceptions and tobacco use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 101:103559. [PMID: 34952281 DOI: 10.1016/j.drugpo.2021.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Public support is an indication of the legitimacy of governmental tobacco interventions. Little is known about what it is that shapes the support for various tobacco policy measures. We examine whether there are differences in public support for new measures against smoking, snus, and e-cigarettes in Norway, and whether public support is associated with user status and perceptions of the products' harm potential. DATA AND METHODS In December 2017, 4,002 people aged between 16 and 89 answered a web-based questionnaire. The sample was randomly drawn from Norstat's web panel, and pre-stratified by gender, age, region, and education in order to obtain an approximate country-representative sample. Respondents were asked to indicate their support for eight possible future measures to further restrict accessibility of tobacco (asked separately with regard to smoking tobacco, snus and e-cigarettes respectively), on a five-point scale from 1 = 'no support' to 5 = 'full support'. We utilized means and t-tests to address differences in support between measures. We then constructed sum scores to assess the total support for regulating each tobacco product and subjected these indexes to linear regression analyses, controlling for background variables. RESULTS For six of the eight proposed measures, public opinion is less supportive of e-cigarette regulations than of similar regulations for snus and, especially, smoking tobacco. In all three regression models, significant associations with risk perception, user status and gender were maintained after multiple controls. The associations with risk perceptions were stronger for support of snus and e-cigarette regulation than for smoking tobacco. CONCLUSION Overall, these findings illustrate the key role of risk perceptions in forming public opinions regarding tobacco-preventive regulations and underline the importance of information to ensure that population risk perceptions are accurate.
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Affiliation(s)
- Gunnar Sæbø
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), P.O. Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Ingeborg Lund
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), P.O. Box 222, Skøyen, N-0213 Oslo, Norway
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Shao Y, Zou J, Xie Z, Mayne RG, Ossip DJ, Rahman I, McIntosh S, Li D. Perceptions of Oral Nicotine Pouches on Reddit: Observational Study (Preprint). J Med Internet Res 2022; 24:e37071. [PMID: 35838764 PMCID: PMC9338421 DOI: 10.2196/37071] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/19/2022] [Accepted: 05/31/2022] [Indexed: 01/18/2023] Open
Abstract
Background Oral nicotine pouches are a new form of tobacco-free nicotine products launched in recent years with a variety of flavors. Objective This study aims to examine the public perceptions and discussions of oral nicotine pouches on Reddit, a popular social media platform for sharing user experiences. Methods Between February 15, 2019, and February 12, 2021, a total of 2410 Reddit posts related to oral nicotine pouches were obtained over a 2-year period. After the removal of unrelated or commercial posts, 653 Reddit posts related to oral nicotine pouches remained. Topics and sentiments related to oral nicotine pouches on Reddit were hand coded. Results The number of Reddit posts related to oral nicotine pouches increased during the study period. Content analysis showed that the most popular topic was “sharing product information and user experience” (366/653, 56%), in which sharing oral nicotine pouch products and user experiences were dominant. The next popular topic was “asking product-related questions” (product properties and product recommendations; 115/653, 17.6%), followed by “quitting nicotine products” such as vaping or smoking through use of oral nicotine pouches or quitting the oral nicotine pouches themselves (83/653, 12.7%) and “discussing oral nicotine pouch–related health” symptoms or concerns related to oral nicotine pouches (74/653, 11.3%). The least popular topic was “legality and permissions” related to oral nicotine pouches (15/653, 2.3%). In addition, a greater number of Reddit posts described positive attitudes compared to negative attitudes toward oral nicotine pouches (354/653, 54.2% vs 101/653, 15.5%; P<.001). Conclusions Reddit posts overall had a positive attitude toward oral nicotine pouches and users were actively sharing product and user experiences. Our study provides the first insight on up-to-date oral nicotine pouch discussions on social media.
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Affiliation(s)
- Yihan Shao
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Jonathan Zou
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Rachel Grana Mayne
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, MD, United States
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
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El-Amin S, Kinnunen JM, Rimpelä A. Adolescents' Perceptions of Harmfulness of Tobacco and Tobacco-like Products in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1485. [PMID: 35162508 PMCID: PMC8834861 DOI: 10.3390/ijerph19031485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/05/2022]
Abstract
During the recent years, new tobacco and tobacco-like products, e.g., e-cigarettes, have emerged on the market. Adolescents often underestimate health risks in general, including those concerning tobacco. Little is known of adolescents' perceptions of health risks of the newer products. Our paper compares adolescents' perceptions of harmfulness of cigarettes, e-cigarettes, snus, water pipes, and nicotine in Finland, a country with a long history of strict tobacco control policy. Online surveys to nationally representative samples of 12-18-year-olds were conducted in 2017 and 2019, with 7578 answering the surveys. Only 3% of boys and 2% of girls did not agree that cigarettes are harmful to health. The percentages were slightly higher for snus (6% and 3%, respectively) and nicotine (12%, 8%) but much higher for e-cigarettes (30%, 22%) and water pipes (36%, 38%). Those who used the product, whose parents were smokers or had lower education, and whose school performance was lower, less often agreed with the harmful health effects of the products. Our results showed that adolescents understood the harmfulness of older tobacco products better than the harmfulness of the newer ones. Our results also showed the need to strengthen health education and fix adolescents' misperceptions of the health effects of the newer products.
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Affiliation(s)
- Salma El-Amin
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (S.E.-A.); (A.R.)
| | - Jaana M. Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (S.E.-A.); (A.R.)
| | - Arja Rimpelä
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (S.E.-A.); (A.R.)
- Department of Adolescent Psychiatry, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
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Dashtian H, Murthy D, Kong G. An Exploration of e-Cigarette-Related Search Items on YouTube: Network Analysis. J Med Internet Res 2022; 24:e30679. [PMID: 35084353 PMCID: PMC8832267 DOI: 10.2196/30679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/27/2021] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background e-Cigarette use among youth is high, which may be due in part to pro–e-cigarette content on social media such as YouTube. YouTube is also a valuable resource for learning about e-cigarette use, trends, marketing, and e-cigarette user perceptions. However, there is a lack of understanding on how similar e-cigarette–related search items result in similar or relatively mutually exclusive search results. This study uses novel methods to evaluate the relationship between e-cigarette–related search items and results. Objective The aim of this study is to apply network modeling and rule-based classification to characterize the relationships between e-cigarette–related search items on YouTube and gauge the level of importance of each search item as part of an e-cigarette information network on YouTube. Methods We used 16 fictitious YouTube profiles to retrieve 4201 distinct videos from 18 keywords related to e-cigarettes. We used network modeling to represent the relationships between the search items. Moreover, we developed a rule-based classification approach to classify videos. We used betweenness centrality (BC) and correlations between nodes (ie, search items) to help us gain knowledge of the underlying structure of the information network. Results By modeling search items and videos as a network, we observed that broad search items such as e-cig had the most connections to other search items, and specific search items such as cigalike had the least connections. Search items with similar words (eg, vape and vaping) and search items with similar meaning (eg, e-liquid and e-juice) yielded a high degree of connectedness. We also found that each node had 18 (SD 34.8) connections (common videos) on average. BC indicated that general search items such as electronic cigarette and vaping had high importance in the network (BC=0.00836). Our rule-based classification sorted videos into four categories: e-cigarette devices (34%-57%), cannabis vaping (16%-28%), e-liquid (14%-37%), and other (8%-22%). Conclusions Our findings indicate that search items on YouTube have unique relationships that vary in strength and importance. Our methods can not only be used to successfully identify the important, overlapping, and unique e-cigarette–related search items but also help determine which search items are more likely to act as a gateway to e-cigarette–related content.
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Affiliation(s)
- Hassan Dashtian
- The Computational Media Lab and School of Journalism and Media, The University of Texas at Austin, Austin, TX, United States
| | - Dhiraj Murthy
- The Computational Media Lab and School of Journalism and Media, The University of Texas at Austin, Austin, TX, United States
| | - Grace Kong
- The Department of Psychiatry at Yale School of Medicine, New Haven, CT, United States
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Rutherford BN, Sun T, Lim CCW, Chung J, Cheng B, Davidson L, Tisdale C, Leung J, Stjepanović D, Connor JP, Chan GCK. Changes in Viewer Engagement and Accessibility of Popular Vaping Videos on TikTok: A 12-Month Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031141. [PMID: 35162170 PMCID: PMC8834819 DOI: 10.3390/ijerph19031141] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/05/2023]
Abstract
AIM There are concerns regarding what young people are exposed to on TikTok due to trending content promoting e-cigarette use through humour, marketing and lifestyle acceptability. Using baseline data from November 2020, we aimed to examine how much content from a sample of popular vaping videos remained accessible at 9- and 12-month follow-ups. We aimed to monitor changes in viewer engagement (using metadata) before and after the U.S. Congressional Hearing on youth protection measures on social media in October 2021. METHODS Hashtag-based keywords were used to collect the most viewed publicly available e-cigarette related videos on TikTok (N = 802) from inception to November 2020 to form a baseline. Researchers conducted a longitudinal descriptive study using this data, with 9- and 12-month follow-ups to measure changes in viewer engagement (using metadata) and content availability. FINDINGS Of the 802 videos from the baseline, 562 remained at the 9-month follow-up and 511 remained at the 12-month follow-up. At the 12-month follow-up, the majority of vaping-related hashtags were removed by TikTok after the Congressional Hearing. Between the baseline and 9-month follow up, views increased by 1.4% and likes increased by 4.4%. At 12-month follow-up, views had increased by 1.7% and likes by 4.2% compared to baseline data. Whilst 291 videos were no longer publicly accessible at 12-month follow-up, 39 of these were made inaccessible by the content creators. The most viewed and most liked vaping videos at baseline were still publicly available. CONCLUSIONS Whilst the depiction type and thematic distribution of removed videos suggest that TikTok may be removing a small proportion of content that promotes the use of e-cigarettes, metadata of remaining videos indicate an increase in viewer engagement. TikTok's removal of explicit substance-related hashtags from the platform could be a step towards preventing adolescents from being exposed to harmful behaviours and substances online. However, the platform should consider enforcing effective age restrictions on content that promotes substance use in a positive light.
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Affiliation(s)
- Brienna N. Rutherford
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
- Correspondence:
| | - Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Carmen C. W. Lim
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Jack Chung
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Brandon Cheng
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Lily Davidson
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Calvert Tisdale
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
- National Drug and Alcohol Research Centre, University of New South Wales, Kensington 2033, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
| | - Jason P. Connor
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- Discipline of Psychiatry, The University of Queensland, Herston 4006, Australia
| | - Gary C. K. Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St. Lucia 4067, Australia; (T.S.); (C.C.W.L.); (J.C.); (B.C.); (J.L.); (D.S.); (J.P.C.); (G.C.K.C.)
- School of Psychology, The University of Queensland, St. Lucia 4067, Australia; (L.D.); (C.T.)
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The Use of E-Cigarettes among High School Students in Poland Is Associated with Health Locus of Control but Not with Health Literacy: A Cross-Sectional Study. TOXICS 2022; 10:toxics10010041. [PMID: 35051083 PMCID: PMC8778307 DOI: 10.3390/toxics10010041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 02/04/2023]
Abstract
Since their introduction, the use of electronic cigarettes has increased considerably in the population and among adolescents. Determinants of smoking conventional cigarettes were thoroughly studied in various social groups. However, we know less about the predictors of the use of e-cigarettes in younger generations. The main aim of this study was the assessment of the factors associated with the use of electronic cigarettes among high school students. Specifically, the roles of health literacy (HL) and health locus of control (HLC) were addressed. The analysis was based on the data from a 'pen-and-pencil' survey performed in a large sample of 2223 high school students from southern Poland. The tools used in the survey encompassed 133 items, including a 47-item European Health Literacy Survey questionnaire, an 18-item Multidimensional Health Locus of Control Scale, and a set of questions asking about the health behaviors, and sociodemographic and economic characteristics of respondents. In the study sample, 47.5% of the respondents had used e-cigarettes in the past, and 18.6% had used them in the last month. HL was not significantly associated with dependent variables reflecting the use of e-cigarettes. Two types of external HLC were associated with using e-cigarettes in the past, and 'Chance' HLC (CHLC) was also associated with their use in the last month. Males, students of schools providing vocational training, and students declaring more Internet use during the week showed a higher likelihood of ever using e-cigarettes or using them in the last month. Students smoking conventional cigarettes were also more prone to use e-cigarettes. To sum up, it was an unexpected result that HL is not associated with the use of e-cigarettes. A greater likelihood of using e-cigarettes was positively associated with higher CHLC scores, as in the case of smoking traditional cigarettes.
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Wee LH, Tee GH, Chan CMH, Draman S, Jamalludin AR, Ho BK, Yn Ling JM, Lim KH, Mohd Yusoff MF, Baharom N, Robson N, Kartiwi M, Ab Rahman NS, Siau CS, Nik Mohamed MH. The Role of Media and Retailer Message Recall on Malaysian Male Perceptions of E-Cigarette Use: The 2016 National Study of E-Cigarettes Prevalence. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221079683. [PMID: 35225040 PMCID: PMC8891842 DOI: 10.1177/00469580221079683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceptions of current smokers on electronic cigarette (EC) use, after exposure to information on EC use and its potential harms from various media and retail outlets. This cross-sectional study is a sub-analysis of the National Study of Electronic Cigarettes Prevalence (N = 4289) using the multi-stage stratified sampling method. Respondents were interviewed face-to-face by a trained data collector using a structured questionnaire printed in both Bahasa Malaysia and English. The analysis included 376 males who smoked conventional cigarettes and/or used ECs and reported ever seeing messages on ECs/vape in various platforms were analyzed using weighted simple and multiple logistic regression. Our findings showed different media types resulted in differing perceptions among smokers towards EC use especially between social media and conventional media. Those exposed to messages promoting EC in social media had higher odds of believing that ECs help people quit smoking (OR: 2.28), the urge to smoke is reduced by ECs (OR: 1.86), ECs are more effective than medication for quitting smoking (OR: 1.96), breathing is improved after using ECs (OR: 2.85), the smell of EC is better than a tobacco cigarette (OR: 2.73), and ECs should be regulated rather than banned completely (OR: 3.08). Vape shops, social, and conventional media provided very different perceptions among smokers towards EC use. Beyond using traditional communication channels, EC promoters have successfully utilized social media to promote ECs among smokers.
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Affiliation(s)
- Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Samsul Draman
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ab Rahman Jamalludin
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Jane Miaw Yn Ling
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Nizam Baharom
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Noorzurani Robson
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mira Kartiwi
- Kulliyyah of ICT, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Norny Syafinaz Ab Rahman
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ching Sin Siau
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
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Lu J, Lee EWJ. Examining Twitter Discourse on Electronic Cigarette and Tobacco Consumption During National Cancer Prevention Month in 2018: Topic Modeling and Geospatial Analysis. J Med Internet Res 2021; 23:e28042. [PMID: 34964716 PMCID: PMC8756341 DOI: 10.2196/28042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/08/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Examining public perception of tobacco products is critical for effective tobacco policy making and public education outreach. While the link between traditional tobacco products and lung cancer is well established, it is not known how the public perceives the association between electronic cigarettes (e-cigarettes) and lung cancer. In addition, it is unclear how members of the public interact with official messages during cancer campaigns on tobacco consumption and lung cancer. Objective In this study, we aimed to analyze e-cigarette and smoking tweets in the context of lung cancer during National Cancer Prevention Month in 2018 and examine how e-cigarette and traditional tobacco product discussions relate to implementation of tobacco control policies across different states in the United States. Methods We mined tweets that contained the term “lung cancer” on Twitter from February to March 2018. The data set contained 13,946 publicly available tweets that occurred during National Cancer Prevention Month (February 2018), and 10,153 tweets that occurred during March 2018. E-cigarette–related and smoking-related tweets were retrieved, using topic modeling and geospatial analysis. Results Debates on harmfulness (454/915, 49.7%), personal experiences (316/915, 34.5%), and e-cigarette risks (145/915, 15.8%) were the major themes of e-cigarette tweets related to lung cancer. Policy discussions (2251/3870, 58.1%), smoking risks (843/3870, 21.8%), and personal experiences (776/3870, 20.1%) were the major themes of smoking tweets related to lung cancer. Geospatial analysis showed that discussion on e-cigarette risks was positively correlated with the number of state-level smoke-free policies enacted for e-cigarettes. In particular, the number of indoor and on campus smoke-free policies was related to the number of tweets on e-cigarette risks (smoke-free indoor, r49=0.33, P=.02; smoke-free campus, r49=0.32, P=.02). The total number of e-cigarette policies was also positively related to the number of tweets on e-cigarette risks (r49=0.32, P=.02). In contrast, the number of smoking policies was not significantly associated with any of the smoking themes in the lung cancer discourse (P>.13). Conclusions Though people recognized the importance of traditional tobacco control policies in reducing lung cancer incidences, their views on e-cigarette risks were divided, and discussions on the importance of e-cigarette policy control were missing from public discourse. Findings suggest the need for health organizations to continuously engage the public in discussions on the potential health risks of e-cigarettes and raise awareness of the insidious lobbying efforts from the tobacco industry.
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Affiliation(s)
- Jiahui Lu
- School of New Media and Communication, Tianjin University, Tianjin, China
| | - Edmund W J Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
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McConaghy K, Kunze KN, Murray T, Molloy R, Piuzzi NS. Smoking Cessation Initiatives in Total Joint Arthroplasty: An Evidence-Based Review. JBJS Rev 2021; 9:01874474-202108000-00012. [PMID: 34449441 DOI: 10.2106/jbjs.rvw.21.00009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» As smoking increases the risk of adverse events and leads to increased hospital costs following total joint arthroplasty (TJA), many institutions have introduced perioperative smoking cessation initiatives. Although such programs have been demonstrated to improve outcomes for smokers undergoing TJA, the optimal approach, duration, and timing of smoking cessation models have not been well-defined. » Overall, initiating a smoking cessation program 4 weeks preoperatively is likely adequate to provide clinically meaningful reductions in postoperative complications for smokers following TJA, although longer periods of cessation should be encouraged if feasible. » Patients brought in for emergency surgical treatment who cannot participate in a preoperative intervention may still benefit from an intervention instituted in the immediate postoperative period. » Cotinine testing may provide some benefit for encouraging successful smoking cessation and validating self-reported smoking status, although its utility is limited by its short half-life. Further study is needed to determine the value of other measures of cessation such as carbon monoxide breath testing. » Smoking cessation programs instituted prior to TJA have been demonstrated to be cost-effective over both the short and long term.
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Affiliation(s)
- Kara McConaghy
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Kyle N Kunze
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY
| | - Trevor Murray
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Robert Molloy
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
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Lee J, Tan ASL, Porter L, Young-Wolff KC, Carter-Harris L, Salloum RG. Association Between Social Media Use and Vaping Among Florida Adolescents, 2019. Prev Chronic Dis 2021; 18:E49. [PMID: 33988495 PMCID: PMC8139446 DOI: 10.5888/pcd18.200550] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION With the growing popularity of vaping, evidence has emerged about the association between social media use and vaping among adolescents, possibly because of the proliferation of e-cigarette advertisements and other related content on social media. Our study examined the association between social media use and vaping among adolescents. METHODS Using data from the 2019 Florida Youth Tobacco Survey (N = 10,776), we conducted logistic regression models on adolescent vaping status (experimental and current vaping) by nondaily and daily use of social media platforms - Facebook, Instagram, Twitter and Snapchat, controlling for other confounders. RESULTS Use of all 4 selected social media platforms was significantly associated with vaping status (P <.001 for all). Once jointly analyzed, daily use of Instagram was significantly associated with increased relative risks of experimental (adjusted relative risk ratio [aRRR] = 1.76; 95% CI, 1.38-2.25) and current vaping (aRRR = 1.51; 95% CI, 1.16-1.95); nondaily use of Snapchat was significantly associated with increased relative risk of experimental (aRRR = 1.57; 95% CI, 1.17-2.10) and current vaping (aRRR = 1.87; 95% CI, 1.31-2.66); daily use of Snapchat was associated with increased relative risk of experimental (aRRR = 2.38; 95% CI, 1.85-3.08) and current vaping (aRRR = 5.09; 95% CI, 3.78-6.86); nondaily use of Facebook was associated with increased relative risk of current vaping (aRRR = 1.20; 95% CI, 1.00-1.43), and nondaily use of Twitter was associated with increased relative risk of current vaping (aRRR = 1.29; 95% CI, 1.07-1.56). CONCLUSION Multilevel efforts are warranted to monitor social media use and vaping status among adolescents, including media use monitoring plans, developing counter-marketing campaigns, and strict regulatory action on social media.
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Affiliation(s)
- Juhan Lee
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida
- 1864 Stadium Rd, FLG 17C, Gainesville, FL 32608.
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lauren Porter
- Bureau of Tobacco Free Florida, Florida Department of Health, Tallahassee, Florida
| | - Kelly C Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Lisa Carter-Harris
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
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Kim SH, Jun J, Thrasher JF, Heo YJ, Cho YJ. News Media Presentations of Heated Tobacco Products (HTPs): A Content Analysis of Newspaper and Television News Coverage in South Korea. JOURNAL OF HEALTH COMMUNICATION 2021; 26:299-311. [PMID: 34156914 DOI: 10.1080/10810730.2021.1931988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Our content analysis of newspaper and television news stories in South Korea examines the quantity and nature of news about novel heated tobacco products (HTPs), which heat instead of burn tobacco and that manufacturers claim are less harmful than cigarettes. The amount of news coverage peaked when the government introduced new regulations, suggesting that HTP news was driven largely by new policies. Indeed, HTPs were more likely to be presented as a policy rather than a health issue. When it comes to news sources, government agencies and HTP manufacturers were referenced most often in the news. As for benefits of HTPs, news stories focused on reduced harm, greater social acceptability, and convenience, while discussions of drawbacks included potentially being equally or more harmful than cigarettes, the possibility of extensive future regulations, and HTPs' unknown health effects. Findings suggested that certain journalistic practices, such as relying heavily on established routine sources, focusing on the stories that could attract large audiences, and representing the perspectives of the publishers and the primary audiences, might have affected the nature of HTP discourse.
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Affiliation(s)
- Sei-Hill Kim
- School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, USA
| | - Jungmi Jun
- School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, USA
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Yu-Jin Heo
- School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, USA
| | - Yoo Jin Cho
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Park E, Kwon M. Testing the Digital Health Literacy Instrument for Adolescents: Cognitive Interviews. J Med Internet Res 2021; 23:e17856. [PMID: 33720031 PMCID: PMC8074835 DOI: 10.2196/17856] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/21/2020] [Accepted: 01/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Despite the increasing number of youth seeking health information on the internet, few studies have been conducted to measure digital health literacy in this population. The digital health literacy instrument (DHLI) is defined as a scale that measures the ability to operate digital devices and read and write in web-based modes, and it assesses seven subconstructs: operational skills, navigation skills, information searching, evaluating reliability, determining relevance, adding self-generated content to a web-based app, and protecting privacy. Currently, there is no validation process of this instrument among adolescents. Objective This study aims to explore the usability and content validity of DHLI. Methods Upon the approval of institutional review board protocol, cognitive interviews were conducted. A total of 34 adolescents aged 10-18 years (n=17, 50% female) participated in individual cognitive interviews. Two rounds of concurrent cognitive interviews were conducted to assess the content validity of DHLI using the thinking aloud method and probing questions. Results Clarity related to unclear wording, undefined technical terms, vague terms, and difficult vocabularies was a major issue identified. Problems related to potentially inappropriate assumptions were also identified. In addition, concerns related to recall bias and socially sensitive phenomena were raised. No issues regarding response options or instrument instructions were noted. Conclusions The initial round of interviews provided a potential resolution to the problems identified with comprehension and communication, whereas the second round prompted improvement in content validity. Dual rounds of cognitive interviews provided substantial insights into survey interpretation when introduced to US adolescents. This study examined the validity of the DHLI and suggests revision points for assessing adolescent digital health literacy.
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Affiliation(s)
- Eunhee Park
- School of Nursing, University at Buffalo, Buffalo, NY, United States
| | - Misol Kwon
- School of Nursing, University at Buffalo, Buffalo, NY, United States
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Tran Luy M, Airagnes G, Matta J, Toubiana L, Allagbe I, Limosin F, Le Faou AL. Sociodemographic and Clinical Characteristics of Vapers Using E-Cigarettes Exclusively: The French Vapoquid Study. Subst Use Misuse 2021; 56:2035-2043. [PMID: 34523386 DOI: 10.1080/10826084.2021.1967987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Electronic cigarettes are increasingly being used as smoking cessation aids. Most studies assess the dual use of e-cigarettes and traditional cigarettes, but there remains a paucity of literature concerning individuals who use e-cigarettes exclusively. Objective: The aim of this study is to examine the sociodemographic and clinical characteristics of exclusive e-cigarette users, and consider their willingness to quit e-cigarette use. Methods: A French online survey was conducted from March to December 2017. We assessed the following factors: sociodemographic factors; the clinical characteristics of e-cigarette use and its social acceptability; and the self-perceived effectiveness of nicotine replacement therapy (NRT). Associations between the listed factors and a willingness to quit e-cigarette use were examined. Results: A total of 386 exclusive e-cigarette users (70% men) participated in the study and were included in the analysis. Most respondents were not planning to quit e-cigarette use (75%). Compared to those who did not want to quit, a desire to quit was associated with using smoking cessation services (OR [95%CI]: 3.45 [1.82-6.56]), e-cigarette craving (OR [95%CI]: 2.63 [1.44-4.80]) and NRT past-use (1.78 [1.12-2.87]). Users who planned to quit expressed more concerns about smoking initiation among youths using e-cigarettes (OR [95%CI]: 3.62 [1.90-6.93]). In multivariate analysis, these associations remained significant for the use of smoking cessation services, e-cigarette cravings, and concerns about youth tobacco initiation. Conclusion: Most exclusive e-cigarette users were not likely to quit. Planned cessation was associated with using smoking cessation services, experiencing e-cigarette dependence symptoms, and being concerned about smoking initiation among teenager e-cigarette users.
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Affiliation(s)
- Marie Tran Luy
- Centre Ambulatoire d'Addictologie, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France
| | - Guillaume Airagnes
- Centre Ambulatoire d'Addictologie, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Joane Matta
- UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | | | - Ingrid Allagbe
- Centre Ambulatoire d'Addictologie, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France
| | - Frédéric Limosin
- UMR_S 1266, Centre Psychiatrie et Neurosciences, Inserm, Paris, France
| | - Anne-Laurence Le Faou
- Centre Ambulatoire d'Addictologie, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Fédération Hospitalo-Universitaire Network of Research in Substance Use Disorder, Paris, France
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Pokhrel P, Ing C, Kawamoto CT, Laestadius L, Buente W, Herzog TA. Social media's influence on e-cigarette use onset and escalation among young adults: What beliefs mediate the effects? Addict Behav 2021; 112:106617. [PMID: 32911352 PMCID: PMC7885807 DOI: 10.1016/j.addbeh.2020.106617] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
As an extension of a previous cross-sectional study, this study employed prospective data to test positive outcome expectancy beliefs as mediators of social media's influence on e-cigarette use progression among young adults. Self-report data were collected from 2327 young adult college students (Mean age = 21.2; SD = 2.1; 54% women) between 2017 and 2019, every 6-month, at 3 time-points. Structural equation modeling was used to test the mediational models. Among baseline never e-cigarette users, higher affect regulation expectancies-e.g., beliefs that e-cigarette use results in feeling good, reduced boredom and stress-mediated the effects of higher baseline social media e-cigarette exposure on e-cigarette use onset one year later. Among baseline lifetime e-cigarette users, higher positive sensory, positive "smoking" experience, and affect regulation expectancy beliefs mediated the effects of higher social media e-cigarette exposure at baseline on increased current e-cigarette use one year later. E-cigarette content on social media may persuade young adults to try e-cigarettes by imparting the sense that e-cigarettes make one feel good and help reduce stress. E-cigarette content on social media that promote e-cigarette flavors and e-cigarettes as cleaner and a socially more acceptable alternative to cigarettes may work to escalate e-cigarette use among experimenters. Efforts to prevent e-cigarette use onset and escalation may need to target the outcome expectancy beliefs influenced by social media.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States.
| | - Claire Ing
- Department of Native Hawaiian Health, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Crissy T Kawamoto
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Linnea Laestadius
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee WI53205, United States
| | - Wayne Buente
- School of Communications, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Thaddeus A Herzog
- Cancer Prevention in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
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McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, Thomson K, Jancey J. E-Cigarette Promotion on Twitter in Australia: Content Analysis of Tweets. JMIR Public Health Surveill 2020; 6:e15577. [PMID: 33151159 PMCID: PMC7677022 DOI: 10.2196/15577] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/20/2019] [Accepted: 09/12/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The sale of electronic cigarettes (e-cigarettes) containing nicotine is prohibited in all Australian states and territories; yet, the growing availability and convenience of the internet enable the promotion and exposure of e-cigarettes across countries. Social media's increasing pervasiveness has provided a powerful avenue to market products and influence social norms and risk behaviors. At present, there is no evidence of how e-cigarettes and vaping are promoted on social media in Australia. OBJECTIVE This study aimed to investigate how e-cigarettes are portrayed and promoted on Twitter through a content analysis of vaping-related tweets containing an image posted and retweeted by Australian users and how the portrayal and promotion have emerged and trended over time. METHODS In total, we analyzed 1303 tweets and accompanying images from 2012, 2014, 2016, and 2018 collected through the Tracking Infrastructure for Social Media Analysis (TrISMA), a contemporary technical and organizational infrastructure for the tracking of public communication by Australian users of social media, via a list of 15 popular e-cigarette-related terms. RESULTS Despite Australia's cautious approach toward e-cigarettes and the limited evidence supporting them as an efficacious smoking cessation aid, it is evident that there is a concerted effort by some Twitter users to promote these devices as a health-conducive (91/129, 70.5%), smoking cessation product (266/1303, 20.41%). Further, Twitter is being used in an attempt to circumvent Australian regulation and advocate for a more liberal approach to personal vaporizers (90/1303, 6.90%). A sizeable proportion of posts was dedicated to selling or promoting vape products (347/1303, 26.63%), and 19.95% (260/1303) were found to be business listings. These posts used methods to try and expand their clientele further than immediate followers by touting competitions and giveaways, with those wanting to enter having to perform a sequence of steps such as liking, tagging, and reposting, ultimately exposing the post among the user's network and to others not necessarily interested in vaping. CONCLUSIONS The borderless nature of social media presents a clear challenge for enforcing Article 13 of the World Health Organization Framework Convention on Tobacco Control, which requires all ratifying nations to implement a ban on tobacco advertising, promotion, and sponsorship. Countering the advertising and promotion of these products is a public health challenge that will require cross-border cooperation with other World Health Organization Framework Convention on Tobacco Control parties. Further research aimed at developing strategies to counter the advertising and promotion of e-cigarettes is therefore needed.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Australia
| | - Bruce Maycock
- College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Bentley, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, Australia
| | - Katie Thomson
- School of Public Health, Curtin University, Bentley, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Australia
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McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, Jancey J. E-Cigarette Advocates on Twitter: Content Analysis of Vaping-Related Tweets. JMIR Public Health Surveill 2020; 6:e17543. [PMID: 33052130 PMCID: PMC7593865 DOI: 10.2196/17543] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/18/2020] [Accepted: 09/12/2020] [Indexed: 01/06/2023] Open
Abstract
Background As the majority of Twitter content is publicly available, the platform has become a rich data source for public health surveillance, providing insights into emergent phenomena, such as vaping. Although there is a growing body of literature that has examined the content of vaping-related tweets, less is known about the people who generate and disseminate these messages and the role of e-cigarette advocates in the promotion of these devices. Objective This study aimed to identify key conversation trends and patterns over time, and discern the core voices, message frames, and sentiment surrounding e-cigarette discussions on Twitter. Methods A random sample of data were collected from Australian Twitter users who referenced at least one of 15 identified e-cigarette related keywords during 2012, 2014, 2016, or 2018. Data collection was facilitated by TrISMA (Tracking Infrastructure for Social Media Analysis) and analyzed by content analysis. Results A sample of 4432 vaping-related tweets posted and retweeted by Australian users was analyzed. Positive sentiment (3754/4432, 84.70%) dominated the discourse surrounding e-cigarettes, and vape retailers and manufacturers (1161/4432, 26.20%), the general public (1079/4432, 24.35%), and e-cigarette advocates (1038/4432, 23.42%) were the most prominent posters. Several tactics were used by e-cigarette advocates to communicate their beliefs, including attempts to frame e-cigarettes as safer than traditional cigarettes, imply that federal government agencies lack sufficient competence or evidence for the policies they endorse about vaping, and denounce as propaganda “gateway” claims of youth progressing from e-cigarettes to combustible tobacco. Some of the most common themes presented in tweets were advertising or promoting e-cigarette products (2040/4432, 46.03%), promoting e-cigarette use or intent to use (970/4432, 21.89%), and discussing the potential of e-cigarettes to be used as a smoking cessation aid or tobacco alternative (716/4432, 16.16%), as well as the perceived health and safety benefits and consequences of e-cigarette use (681/4432, 15.37%). Conclusions Australian Twitter content does not reflect the country’s current regulatory approach to e-cigarettes. Rather, the conversation on Twitter generally encourages e-cigarette use, promotes vaping as a socially acceptable practice, discredits scientific evidence of health risks, and rallies around the idea that e-cigarettes should largely be outside the bounds of health policy. The one-sided nature of the discussion is concerning, as is the lack of disclosure and transparency, especially among vaping enthusiasts who dominate the majority of e-cigarette discussions on Twitter, where it is unclear if comments are endorsed, sanctioned, or even supported by the industry.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Australia
| | - Bruce Maycock
- College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Bentley, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Australia
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Schillinger D, Chittamuru D, Ramírez AS. From "Infodemics" to Health Promotion: A Novel Framework for the Role of Social Media in Public Health. Am J Public Health 2020; 110:1393-1396. [PMID: 32552021 DOI: 10.2105/ajph.2020.305746] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Despite the ubiquity of health-related communications via social media, no consensus has emerged on whether this medium, on balance, jeopardizes or promotes public health. During the COVID-19 pandemic, social media has been described as the source of a toxic "infodemic" or a valuable tool for public health. No conceptual model exists for examining the roles that social media can play with respect to population health.We present a novel framework to guide the investigation and assessment of the effects of social media on public health: the SPHERE (Social media and Public Health Epidemic and REsponse) continuum. This model illustrates the functions of social media across the epidemic-response continuum, ranging across contagion, vector, surveillance, inoculant, disease control, and treatment.We also describe attributes of the communications, diseases and pathogens, and hosts that influence whether certain functions dominate over others. Finally, we describe a comprehensive set of outcomes relevant to the evaluation of the effects of social media on the public's health.
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Affiliation(s)
- Dean Schillinger
- Dean Schillinger is with the Health Communications Research Program, Center for Vulnerable Populations, San Francisco General Hospital, University of California, San Francisco. Deepti Chittamuru and A. Susana Ramírez are with the Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced
| | - Deepti Chittamuru
- Dean Schillinger is with the Health Communications Research Program, Center for Vulnerable Populations, San Francisco General Hospital, University of California, San Francisco. Deepti Chittamuru and A. Susana Ramírez are with the Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced
| | - A Susana Ramírez
- Dean Schillinger is with the Health Communications Research Program, Center for Vulnerable Populations, San Francisco General Hospital, University of California, San Francisco. Deepti Chittamuru and A. Susana Ramírez are with the Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced
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