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Castillo-Toledo C, Fernandez-Lazaro CI, Lara-Abelenda FJ, Molina-Ruiz RM, Ortega MA, Mora F, Alvarez-Mon M, Quintero J, Alvarez-Mon MA. Regional insights on tobacco-related tweets: unveiling user opinions and usage patterns. Front Public Health 2024; 12:1342460. [PMID: 38947344 PMCID: PMC11211802 DOI: 10.3389/fpubh.2024.1342460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/27/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Tobacco consumption and its impact on health remain high worldwide. Additionally, it is a contentious issue generating significant controversy. Twitter has proven to be a useful platform for evaluating public health topics related to population health behaviors, and tobacco consumption. Objective The objective of this study is to analyze the content of tweets related to tobacco. Moreover, geolocation data will be considered to understand regional differences. Methods Tweets published between 2018 and 2022, in both English and Spanish, containing the keyword "tobacco," were analyzed. A total of 56,926 tweets were obtained. The tweets were classified into different categories. 550 tweets were manually analyzed, and an automated and computerized classification was performed for the remaining and largest subset of tweets. Results The analysis yielded 30,812 classifiable tweets. Healthcare professionals were the most frequent contributors to the topic (50.2%), with the most common theme being general information about the toxic effects of tobacco. 57.9% of the tweets discussed the harmful effects of tobacco on health, with fear being the predominant emotion. The largest number of tweets were located in America. Conclusions Our study revealed a substantial number of tweets highlighting the health risks and negative perceptions of tobacco consumption. Africa showed the lowest percentage of tweets discussing the health risks associated with tobacco, coinciding with the continent having the least developed anti-tobacco policies. Healthcare professionals emerged as the most prominent users discussing the topic, which is encouraging as they play a crucial role in disseminating accurate and scientific health information.
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Affiliation(s)
- Consuelo Castillo-Toledo
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Cesar I. Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco J. Lara-Abelenda
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Departamento Teoria de la Señal y Comunicaciones y Sistemas Telemáticos y Computación, Escuela Tecnica Superior de Ingenieria de Telecomunicación, Universidad Rey Juan Carlos, Municipality of Fuenlabrada, Spain
| | - Rosa M. Molina-Ruiz
- Department of Psychiatry and Mental, Health San Carlos University Hospital (HCSC), Madrid, Spain
- Research Biomedical Foundation of Clinico San Carlos Hospital (IDISCC), Madrid, Spain
| | - Miguel Angel Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Ramón y Cajal Hospital, Madrid, Spain
| | - Fernando Mora
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
- Department of Legal and Psychiatry, Complutense University, Madrid, Spain
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Ramón y Cajal Hospital, Madrid, Spain
- Immune System Diseases-Rheumatology and Internal Medicine Service, CIBEREHD, University Hospital Príncipe de Asturias, Alcalá de Henares, Spain
| | - Javier Quintero
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
- Department of Legal and Psychiatry, Complutense University, Madrid, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Ramón y Cajal Hospital, Madrid, Spain
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
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Allem JP, Rodriguez V, Pattarroyo M, Ramirez CM, Beard TA, Soto D, Donaldson SI, Unger JB. Spanish-Language Tobacco-Related Posts on Twitter: Content Analysis. Nicotine Tob Res 2024; 26:759-763. [PMID: 37942524 DOI: 10.1093/ntr/ntad220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/02/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Twitter data have been used to surveil public sentiment about tobacco products; however, most tobacco-related Twitter research has been conducted with English-language posts. There is a gap in the literature on tobacco-related discussions on Twitter in languages other than English. This study summarized tobacco-related discussions in Spanish on Twitter. METHODS A set of Spanish terms reflecting electronic cigarettes (eg, "cigarillos electrónicos"), cigarettes (eg, "pitillo"), and cigars (eg, "cigaro") were identified. A content analysis of tweets (n = 1352) drawn from 2021 was performed to examine themes and sentiment. An initial codebook was developed in English then translated to Spanish and then translated back to English by a bilingual (Spanish and English) member of the research team. Two bilingual members of the research team coded the tweets into themes and sentiment. RESULTS Themes in the tweets included (1) product promotion (n = 168, 12.4%), (2) health warnings (n = 161, 11.9%), (3) tobacco use (n = 136, 10.1%), (4) health benefits of vaping (n = 58, 4.3%), (5) cannabis use (n = 50, 3.7%), (6) cessation (n = 47, 3.5%), (7) addiction (n = 33, 2.4%), (8) policy (n = 27, 2.0%), and (9) polysubstance use (n = 12, 0.9%). Neutral (n = 955, 70.6%) was the most common category of sentiment observed in the data. CONCLUSIONS Tobacco products are discussed in multiple languages on Twitter and can be summarized by bilingual research teams. Future research should determine if Spanish-speaking individuals are frequently exposed to pro-tobacco content on social media and if such exposure increases susceptibility to use tobacco among never users or sustained use among current users. IMPLICATIONS Spanish-language pro-tobacco content exists on Twitter, which has implications for Spanish-speaking individuals who may be exposed to this content. Spanish-language pro-tobacco-related posts may help normalize tobacco use among Spanish-speaking populations. As a result, anti-tobacco tweets in Spanish may be necessary to counter areas of the online environment that can be considered pro-tobacco.
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Affiliation(s)
- Jon-Patrick Allem
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Viviana Rodriguez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Monica Pattarroyo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carla M Ramirez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Trista A Beard
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Scott I Donaldson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Lee J, Ouellette RR, Morean ME, Kong G. Adolescents and Young Adults Use of Social Media and Following of e-Cigarette Influencers. Subst Use Misuse 2024; 59:1424-1430. [PMID: 38755112 DOI: 10.1080/10826084.2024.2352620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND With high rates of both e-cigarette and social media use among adolescents and young adults (AYAs), social media influencers who promote e-cigarettes are particularly concerning but are understudied. We examined the association between AYAs' use of 11 different social media platforms (e.g. Facebook, Twitter, Instagram, TikTok, and YouTube) and exposure to social media e-cigarette influencers. OBJECTIVES From November 2022 to February 2023, we conducted an online, US national survey of AYAs (14-29 years) who endorsed past-30-day e-cigarette use. We used binomial logistic regression to examine associations between the frequency of use of each social media platform and following e-cigarette influencers, controlling for age, sex, race, ethnicity, e-cigarette use frequency, and other tobacco and substance use (i.e., alcohol and cannabis). The model was stratified by adolescents (14-17 years; n = 293) and young adults (18-29 years; n = 654). RESULTS The most frequently used social media platforms were Snapchat, TikTok and Instagram among adolescents, and YouTube, Instagram and TikTok among young adults. In adjusted models, following e-cigarette influencers was associated with more frequent use of TikTok (adjusted odds ratio [95% CI]; 1.33 [1.05, 1.68]) and Pinterest (1.18 [1.02, 1.38]) among adolescents, and more frequent use of Twitter (1.17 [1.06, 1.29]) among young adults. CONCLUSIONS The use of different platforms was associated with exposure to e-cigarette influencers: TikTok and Pinterest among adolescents and Twitter among young adults. These findings can inform tobacco regulatory policy and social media platform restrictions of e-cigarette influencers on the platforms that are popular among AYAs.
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Affiliation(s)
- Juhan Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rachel R Ouellette
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Meghan E Morean
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Grace Kong
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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Zhou R, Xie Z, Tang Q, Li D. Social Network Analysis of e-Cigarette-Related Social Media Influencers on Twitter/X: Observational Study. JMIR Form Res 2024; 8:e53666. [PMID: 38557555 PMCID: PMC11019427 DOI: 10.2196/53666] [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: 10/14/2023] [Revised: 01/29/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND An e-cigarette uses a battery to heat a liquid that generates an aerosol for consumers to inhale. e-Cigarette use (vaping) has been associated with respiratory disease, cardiovascular disease, and cognitive functions. Recently, vaping has become increasingly popular, especially among youth and young adults. OBJECTIVE The aim of this study was to understand the social networks of Twitter (now rebranded as X) influencers related to e-cigarettes through social network analysis. METHODS Through the Twitter streaming application programming interface, we identified 3,617,766 unique Twitter accounts posting e-cigarette-related tweets from May 3, 2021, to June 10, 2022. Among these, we identified 33 e-cigarette influencers. The followers of these influencers were grouped according to whether or not they post about e-cigarettes themselves; specifically, the former group was defined as having posted at least five e-cigarette-related tweets in the past year, whereas the latter group was defined as followers that had not posted any e-cigarette-related tweets in the past 3 years. We randomly sampled 100 user accounts among each group of e-cigarette influencer followers and created corresponding social networks for each e-cigarette influencer. We compared various network measures (eg, clustering coefficient) between the networks of the two follower groups. RESULTS Major topics from e-cigarette-related tweets posted by the 33 e-cigarette influencers included advocating against vaping policy (48.0%), vaping as a method to quit smoking (28.0%), and vaping product promotion (24.0%). The follower networks of these 33 influencers showed more connections for those who also post about e-cigarettes than for followers who do not post about e-cigarettes, with significantly higher clustering coefficients for the former group (0.398 vs 0.098; P=.005). Further, networks of followers who post about e-cigarettes exhibited substantially more incoming and outgoing connections than those of followers who do not post about e-cigarettes, with significantly higher in-degree (0.273 vs 0.084; P=.02), closeness (0.452 vs 0.137; P=.04), betweenness (0.036 vs 0.008; P=.001), and out-of-degree (0.097 vs 0.014; P=.02) centrality values. The followers who post about e-cigarettes also had a significantly (P<.001) higher number of followers (n=322) than that of followers who do not post about e-cigarettes (n=201). The number of tweets in the networks of followers who post about e-cigarettes was significantly higher than that in the networks of followers who do not post about e-cigarettes (93 vs 43; P<.001). Two major topics discussed in the networks of followers who post about e-cigarettes included promoting e-cigarette products or vaping activity (55.7%) and vaping being a help for smoking cessation and harm reduction (44.3%). CONCLUSIONS Followers of e-cigarette influencers who also post about e-cigarettes have more closely connected networks than those of followers who do not themselves post about e-cigarettes. These findings provide a potentially practical intervention approach for future antivaping campaigns.
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Affiliation(s)
- Runtao Zhou
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Qihang Tang
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, United States
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Jancey J, Crawford G, Bowman E, Wolf K, Leaver T, Bialous S, McCausland K. Perceptions of social media harms and potential management strategies: vaping case study. BMC Public Health 2024; 24:876. [PMID: 38515083 PMCID: PMC10958968 DOI: 10.1186/s12889-024-18362-8] [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: 12/11/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The social media landscape is now ubiquitous in people's everyday lives. It is a space where culture, politics, economics and sociological and public health discourses occur. There is mounting evidence that e-cigarette products are being promoted and advertised on social media, a media platform particularly popular with young people. Our research aimed to understand industry professionals' perceptions of social media harms and potential management strategies using vaping as a case study. METHODS A critical realist perspective guided reflexive thematic analysis of the qualitative in depth, semi structured interviews. Data collection occurred in January and February 2023 with 13 participants working in the areas of public health, digital media, law, governance, tobacco control and advocacy. RESULTS Two superordinate themes emerged from the data: (1) Fathoming a complex system (social media) that contained the subordinate themes of Traversing Boundaries (crossing borders, crossing sectors) and Ungovernable (global and local landscapes, vested interests, self-regulation and opacity). (2) Addressing complexity (social media)- that contained the subordinate themes of Strengthening Institutions (global to local, policy and legislation, individuals and organisations); Defanging Industry (responsibility and transparency, moderation and algorithms, complaints); and Engaging Citizens (raising awareness, framing messaging). CONCLUSIONS There was consensus among participants that e-cigarette related social media content can be harmful and government action is urgently needed. There was an identified need for the development of government led national-level regulatory frameworks, with government led appropriate legislation; identification of an organisation or organisations with suitable levels of regulatory power and resources to monitor, enforce and penalise noncompliant social media companies; accompanied by increased community awareness raising of harmful social media content and improved digital literacy.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia.
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Elizabeth Bowman
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Katharina Wolf
- School of Management and Marketing, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Stella Bialous
- School of Nursing, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
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Ng L, Ng XY, van der Eijk Y. Vaping in a heavily regulated setting: cross-sectional survey of e-cigarette use, perceptions and social media exposure. Tob Control 2024; 33:e11-e17. [PMID: 36813571 DOI: 10.1136/tc-2022-057805] [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: 10/10/2022] [Accepted: 02/11/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Singapore has completely banned e-cigarettes and the government's cautious stance against vaping has been consistent. Despite this, vaping appears to have gained popularity in Singapore, especially among younger people. With the heavy marketing of vaping products on social media, it is possible that such marketing, due to its cross-border nature, is reaching younger Singaporeans and driving changes in vaping-related perceptions or behaviours. This study examines their exposure to vaping-related content on social media, and whether such exposure is associated with more positive perceptions of vaping or e-cigarette ever use. METHODS Analysis of cross-sectional survey data of 550 adult (age 21-40 years) Singaporeans recruited via convenience methods in May 2022, using descriptive statistics, bivariate analyses, and multiple linear and logistic regression models. RESULTS 16.9% of participants reported they had ever used e-cigarettes. 18.5% of those who used social media recalled seeing vaping-related content on a social media platform in the past 6 months, mostly from influencers or friends, and on Instagram, Facebook, TikTok and/or YouTube. Reporting exposure to such content was not associated with e-cigarette ever use. It was associated with having a more positive overall perception of vaping (β=1.47; 95% CI: 0.17 to 2.78), although no significant difference was observed when examining only health-related perceptions. CONCLUSION Even in a heavily regulated environment such as Singapore's, people appear to be exposed to vaping-related content on social media platforms and this exposure is, in turn, associated with more positive perceptions of vaping, but not e-cigarette ever use.
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Affiliation(s)
- Lionel Ng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Xian Yi Ng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Xie Z, Deng S, Liu P, Lou X, Xu C, Li D. Characterizing Anti-Vaping Posts for Effective Communication on Instagram Using Multimodal Deep Learning. Nicotine Tob Res 2024; 26:S43-S48. [PMID: 38366336 PMCID: PMC10873495 DOI: 10.1093/ntr/ntad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/28/2023] [Accepted: 09/27/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Instagram is a popular social networking platform for sharing photos with a large proportion of youth and young adult users. We aim to identify key features in anti-vaping Instagram image posts associated with high social media user engagement by artificial intelligence. AIMS AND METHODS We collected 8972 anti-vaping Instagram image posts and hand-coded 2200 Instagram images to identify nine image features such as warning signs and person-shown vaping. We utilized a deep-learning model, the OpenAI: contrastive language-image pre-training with ViT-B/32 as the backbone and a 5-fold cross-validation model evaluation, to extract similar features from the Instagram image and further trained logistic regression models for multilabel classification. Latent Dirichlet Allocation model and Valence Aware Dictionary and sEntiment Reasoner were used to extract the topics and sentiment from the captions. Negative binomial regression models were applied to identify features associated with the likes and comments count of posts. RESULTS Several features identified in anti-vaping Instagram image posts were significantly associated with high social media user engagement (likes or comments), such as educational warnings and warning signs. Instagram posts with captions about health risks associated with vaping received significantly more likes or comments than those about help quitting smoking or vaping. Compared to the model based on 2200 hand-coded Instagram image posts, more significant features have been identified from 8972 AI-labeled Instagram image posts. CONCLUSION Features identified from anti-vaping Instagram image posts will provide a potentially effective way to communicate with the public about the health effects of e-cigarette use. IMPLICATIONS Considering the increasing popularity of social media and the current vaping epidemic, especially among youth and young adults, it becomes necessary to understand e-cigarette-related content on social media. Although pro-vaping messages dominate social media, anti-vaping messages are limited and often have low user engagement. Using advanced deep-learning and statistical models, we identified several features in anti-vaping Instagram image posts significantly associated with high user engagement. Our findings provide a potential approach to effectively communicate with the public about the health risks of vaping to protect public health.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Shijian Deng
- Department of Computer Science, University of Rochester, Rochester, NY, USA
| | - Pinxin Liu
- Department of Computer Science, University of Rochester, Rochester, NY, USA
| | - Xubin Lou
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, USA
| | - Chenliang Xu
- Department of Computer Science, University of Rochester, Rochester, NY, USA
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, USA
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Jancey J, Carey RN, Freeman B, Leaver T, Wolf K, Bromberg M, Chai K, Bialous S, Adams P, Mcleod M, McCausland K. E-cigarettes on Instagram: Exploring vape content via an Australian vaping influencer. Tob Induc Dis 2024; 22:TID-22-19. [PMID: 38250632 PMCID: PMC10798224 DOI: 10.18332/tid/175619] [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: 10/09/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Mounting evidence suggests that electronic cigarettes (e-cigarettes) are extensively promoted and marketed using social media, including through user-generated content and social media influencers. This study explores how e-cigarettes are being promoted on Instagram, using a case-study approach, and the extent to which Meta's Restricted Goods and Services Policy (Meta's policy) is being applied and enforced. METHODS We identified the accounts followed by an Australian Instagram influencer who primarily posts e-cigarette-related content. The main foci of these 855 accounts were coded and 369 vaping-focused accounts were identified. These vaping-focused accounts were then further coded by two trained coders. RESULTS All (n=369; 100.0%) of the vape content posted by these accounts was positive in sentiment. One-third of the vape accounts (n=127; 34.4%) had a shared focus, indicating that vape content may permeate into other online communities through shared interests. A total of 64 accounts (17.3%) potentially violated Meta's policy by attempting to purchase, sell, raffle or gift e-cigarette products. CONCLUSIONS The findings of this study suggest that pro-vaping information is available and accessible on Instagram. Much of the content identified in this study promoted the purchase or gifting of e-cigarette products and potentially violates Meta's policy. Greater regulation and/or stronger enforcement of e-cigarette content on social media platforms such as Instagram is necessary to prevent the ongoing promotion of these harmful products.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Renee N. Carey
- School of Population Health, Curtin University, Bentley, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, Australia
| | - Tama Leaver
- Internet Studies, School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Australia
| | - Katharina Wolf
- School of Management and Marketing, Curtin University, Bentley, Australia
| | - Marilyn Bromberg
- Law School, The University of Western Australia, Crawley, Australia
| | - Kevin Chai
- School of Population Health, Curtin University, Bentley, Australia
| | - Stella Bialous
- School of Nursing, University of California, San Francisco, United States
| | - Phoebe Adams
- Collaboration for Evidence, Research and Impact in Public Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Meghan Mcleod
- Collaboration for Evidence, Research and Impact in Public Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
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Mathieson S, O'Keeffe M, Traeger AC, Ferreira GE, Abdel Shaheed C. Content and sentiment analysis of gabapentinoid-related tweets: An infodemiology study. Drug Alcohol Rev 2024; 43:45-55. [PMID: 36539307 DOI: 10.1111/dar.13590] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The increasing number of gabapentinoid (pregabalin and gabapentin) harms, including deaths observed across countries is concerning to health-care professionals and policy makers. However, it is unclear if the public shares these concerns. This study aimed to describe posts related to gabapentinoids, conduct a content analysis to identify common themes and describe adverse events or symptoms. METHODS Keywords of 'pregabalin' or 'Lyrica' or 'gabapentin' or 'Neurontin' were used to search for related tweets posted by people in the community between 8 March and 7 May 2021. Eligible tweets included a keyword in the post. We extracted de-identified data which included descriptive data of the total number of posts over time; and data on individual tweets including date, number of re-tweets and post content. Data were exported separately for pregabalin- and gabapentin-related tweets. A 20% random sample was used for the thematic analysis. RESULTS There were 2931 pregabalin-related tweets and 2736 gabapentin-related tweets. Thematic analysis revealed three themes (sharing positive experiences and benefits of taking gabapentinoids, people voicing their negative experiences, and people seeking opinions and sharing information). Positive experiences of gabapentinoids were related to sharing stories and giving advice. This was contrasted to negative experiences including ineffectiveness, withdrawals, side effects and frustration related to cost and insurance coverage. Brain fog was the most common adverse symptom reported. Gabapentinoid-related deaths were only mentioned in three tweets. DISCUSSION The increasing public health concern of gabapentinoid-related deaths was not translated to Twitter discussions.
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Affiliation(s)
- Stephanie Mathieson
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Mary O'Keeffe
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian C Traeger
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Giovanni E Ferreira
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Christina Abdel Shaheed
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Al-Rawi A, Blackwell B, Zemenchik K, Lee K. Twitter Misinformation Discourses About Vaping: Systematic Content Analysis. J Med Internet Res 2023; 25:e49416. [PMID: 37948118 PMCID: PMC10674139 DOI: 10.2196/49416] [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: 05/28/2023] [Revised: 08/23/2023] [Accepted: 09/22/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND While there has been substantial analysis of social media content deemed to spread misinformation about electronic nicotine delivery systems use, the strategic use of misinformation accusations to undermine opposing views has received limited attention. OBJECTIVE This study aims to fill this gap by analyzing how social media users discuss the topic of misinformation related to electronic nicotine delivery systems, notably vaping products. Additionally, this study identifies and analyzes the actors commonly blamed for spreading such misinformation and how these claims support both the provaping and antivaping narratives. METHODS Using Twitter's (subsequently rebranded as X) academic application programming interface, we collected tweets referencing #vape and #vaping and keywords associated with fake news and misinformation. This study uses systematic content analysis to analyze the tweets and identify common themes and actors who discuss or possibly spread misinformation. RESULTS This study found that provape users dominate the platform regarding discussions about misinformation about vaping, with provaping tweets being more frequent and having higher overall user engagement. The most common narrative for provape tweets surrounds the conversation of vaping being perceived as safe. On the other hand, the most common topic from the antivape narrative is that vaping is indeed harmful. This study also points to a general distrust in authority figures, with news outlets, public health authorities, and political actors regularly accused of spreading misinformation, with both placing blame. However, specific actors differ depending on their positionalities. The vast number of accusations from provaping advocates is found to shape what is considered misinformation and works to silence other narratives. Additionally, allegations against reliable and proven sources, such as public health authorities, work to discredit assessments about the health impacts, which is detrimental to public health overall for both provaping and antivaping advocates. CONCLUSIONS We conclude that the spread of misinformation and the accusations of misinformation dissemination using terms such as "fact check," "misinformation," "fake news," and "disinformation" have become weaponized and co-opted by provaping actors to delegitimize criticisms about vaping and to increase confusion about the potential health risks. The study discusses the mixed types of impact of vaping on public health for both smokers and nonsmokers. Additionally, we discuss the implications for effective health education and communication about vaping and how misinformation claims can affect evidence-based discourse on Twitter as well as informed vaping decisions.
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Affiliation(s)
| | | | | | - Kelley Lee
- Simon Fraser University, Burnaby, BC, Canada
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11
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Jancey J, Leaver T, Wolf K, Freeman B, Chai K, Bialous S, Bromberg M, Adams P, Mcleod M, Carey RN, McCausland K. Promotion of E-Cigarettes on TikTok and Regulatory Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5761. [PMID: 37239490 PMCID: PMC10217796 DOI: 10.3390/ijerph20105761] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/22/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023]
Abstract
E-cigarettes are promoted extensively on TikTok and other social media platforms. Platform policies to restrict e-cigarette promotion seem insufficient and are poorly enforced. This paper aims to understand how e-cigarettes are being promoted on TikTok and provide insights into the effectiveness of current TikTok policies. Seven popular hashtag-based keywords were used to identify TikTok accounts and associated videos related to e-cigarettes. Posts were independently coded by two trained coders. Collectively, the 264 videos received 2,470,373 views, 166,462 likes and 3426 comments. The overwhelming majority of videos (97.7%) portrayed e-cigarettes positively, and these posts received 98.7% of the total views and 98.2% of the total likes. A total of 69 posts (26.1%) clearly violated TikTok's own content policy. The findings of the current study suggest that a variety of predominantly pro-vaping content is available on TikTok. Current policies and moderation processes appear to be insufficient in restricting the spread of pro-e-cigarette content on TikTok, putting predominantly young users at potential risk of e-cigarette use.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Tama Leaver
- Internet Studies, School of Media, Creative Arts and Social Inquiry, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Kevin Chai
- School of Population Health, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Stella Bialous
- School of Nursing, University of California, San Francisco, CA 94158, USA
| | - Marilyn Bromberg
- UWA Law School, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | - Phoebe Adams
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Meghan Mcleod
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Renee N. Carey
- School of Population Health, Curtin University, Kent Street, Perth, WA 6102, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA 6102, Australia
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12
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Lim YS, Lee JY. A Comparative Analysis of E-Cigarette and Cigarette Posts on Instagram. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3116. [PMID: 36833814 PMCID: PMC9967293 DOI: 10.3390/ijerph20043116] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
E-cigarette use has grown rapidly over the past decade and become a threat to public health. Marketing-especially through social media-has contributed significantly to this growth, which suggests that regulating content in social media will be critical in supporting efforts to reverse this trend. A content analysis was performed to compare 254 e-cigarette posts on Instagram with 228 cigarette posts on the same platform. The majority of e-cigarette posts were from e-cigarette companies (40.9%) and industry people (18.5%), whereas the majority of cigarette posts were from laypeople (76.8%). More e-cigarette posts than cigarette posts appeared to have a marketing intent (56.3% vs. 1.3%), and brand representation in photographs/videos was more frequent in the e-cigarette posts than in the cigarette posts (63.0% vs. 15.8%). Further, compared with the e-cigarette posts, the cigarette posts were more likely to portray daily life (73.2% vs. 41.3%) and humans (80.3% vs. 43.7%) in the photograph/video. The cigarette posts also portrayed smoking much more often than the e-cigarette posts portrayed vaping (67.1% vs. 21.3%). The study findings broaden the field's understanding of cigarette and e-cigarette content on Instagram and social media, and have implications for monitoring and regulating content for e-cigarettes and cigarettes.
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Affiliation(s)
- Young-shin Lim
- Graduate School of Business, Sejong University, Seoul 05006, Republic of Korea
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13
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Mavragani A, Tang Q, Xie Z, Li D. Public Perceptions of the Food and Drug Administration's Proposed Rules Prohibiting Menthol Cigarettes on Twitter: Observational Study. JMIR Form Res 2023; 7:e42706. [PMID: 36763414 PMCID: PMC9960014 DOI: 10.2196/42706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/09/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND On April 28, 2022, the Food and Drug Administration (FDA) proposed rules that prohibited all menthol-flavored cigarettes and other flavored cigars to prevent the initiation of tobacco use in youth and reduce tobacco-related diseases and death. OBJECTIVE The objective of this study was to investigate public perceptions of the FDA's proposed menthol cigarette rules on Twitter. METHODS Through the Twitter streaming application programming interface, tobacco-related tweets were collected between April 28, 2022, and May 27, 2022, using a set of keywords, such as smoking, cigarette, and nicotine. Furthermore, 1941 tweets related to the FDA's proposed menthol cigarette rules were extracted. Based on 300 randomly selected example tweets, the codebook for the attitudes toward the FDA's proposed rules and related topics was developed by 2 researchers and was used to label the rest of the tweets. RESULTS Among tweets related to the FDA's proposed menthol cigarette rules, 536 (27.61%) showed a positive attitude, 443 (22.82%) had a negative attitude, and 962 (49.56%) had a neutral attitude toward the proposed rules. Social justice (210/536, 39%) and health issues (117/536, 22%) were two major topics in tweets with a positive attitude. For tweets with a negative attitude, alternative tobacco or nicotine products (127/443, 29%) and racial discrimination (84/536, 16%) were two of the most popular topics. CONCLUSIONS In general, the public had a positive attitude toward the FDA's proposed menthol cigarette rules. Our study provides important information to the FDA on the public perceptions of the proposed menthol cigarette rules, which will be helpful for future FDA regulations on menthol cigarettes.
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Affiliation(s)
| | - Qihang Tang
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, United States
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14
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Lou X, Liu P, Xie Z, Li D. Public Perceptions on the Policy of Electronic Cigarettes as Medical Products on Twitter. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2618. [PMID: 36767983 PMCID: PMC9915110 DOI: 10.3390/ijerph20032618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Starting from 1 October 2021, Australia requires a prescription for purchasing nicotine vaping products. On 29 October 2021, the UK provided a guideline to treat e-cigarettes as medical products. This study aims to understand public perceptions of the prescription policy in Australia and the UK on Twitter. Tweets related to e-cigarettes from 20 September 2021 to 31 December 2021 were collected through Twitter streaming API. We adopted both a human and machine learning model to identify a total of 1795 tweets from the UK and Australia related to the prescription policy. We classified them into pro-policy, anti-policy, and neutral-to-policy groups, and further characterized tweets into different topics. Compared to Australia, the proportion of pro-policy tweets in the UK was significantly higher (19.43% vs. 10.92%, p < 0.001), while the proportion of anti-policy tweets was significantly lower (43.4% vs. 50.09%, p = 0.003). The main topics for different attitudes towards the prescription policy between the two countries showed some significant differences, for example, "help quit smoking" in the UK and "health effect of e-cigarettes" in Australia for the positive attitude, "economic effect" in the UK and "preventing smoking cessation" in Australia for the negative attitude, which reflected different public concerns. The findings might provide valuable guidance for other countries to implement a similar policy in the future.
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Affiliation(s)
- Xubin Lou
- Goergen Institute for Data Science, University of Rochester, Rochester, NY 14627, USA
| | - Pinxin Liu
- Department of Computer Science, University of Rochester, Rochester, NY 14627, USA
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
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15
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Rutherford BN, Lim CCW, Johnson B, Cheng B, Chung J, Huang S, Sun T, Leung J, Stjepanović D, Chan GCK. #TurntTrending: a systematic review of substance use portrayals on social media platforms. Addiction 2023; 118:206-217. [PMID: 36075258 PMCID: PMC10087142 DOI: 10.1111/add.16020] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/21/2022] [Indexed: 01/05/2023]
Abstract
AIMS There is a growing body of literature exploring the types of substance-related content and their portrayals on various social media platforms. We aimed to summarize how content related to substances is portrayed on various social media platforms. METHODS This systematic review was pre-registered on PROSPERO (ref: CRD42021291853). A comprehensive search was conducted in the databases of PubMed, Scopus, PsycINFO and Web of Science in April 2021. Original qualitative studies published post-2004 that included thematic and sentiment analyses of social media content on tobacco, alcohol, psychostimulant, e-cigarette, cannabis, opiate, stimulant/amphetamine, inhalant and novel psychoactive substance were included. Social media platforms were defined as online web- or application-based platforms that allowed users to generate content and interact via 'liking', comment or messaging features. Only studies that included summative and/or thematic content analyses of substance-related social media content were included. RESULTS A total of 73 studies, which covered 15 905 182 substance-related posts on Twitter, YouTube, Instagram, Pinterest, TikTok and Weibo, were identified. A total of 76.3% of all substance-related content was positive in its depiction of substance use, with 20.2% of content depicting use negatively. Sentiment regarding opiate use however was commonly negative (55.5%). Most studies identified themes relating to Health, Safety and Harms (65.0%) of substance use. Themes relating to Promotions/Advertisements (63.3%), Informative content (55.0%) and Use behaviours (43.3%) were also frequently identified. CONCLUSIONS Substance-related content that promotes engagement with substance use or actively depicts use appears to be widely available on social media. The large public presence of this content may have concerning influences on attitudes, behaviours and risk perceptions relating to substance use, particularly among the most vulnerable and heaviest users of social media-adolescents and young adults.
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Affiliation(s)
- Brienna N Rutherford
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.,School of Psychology, The University of Queensland, St Lucia, Australia
| | - Carmen C W Lim
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.,School of Psychology, The University of Queensland, St Lucia, Australia
| | - Benjamin Johnson
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.,School of Psychology, The University of Queensland, St Lucia, Australia
| | - Brandon Cheng
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.,School of Psychology, The University of Queensland, St Lucia, Australia
| | - Jack Chung
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.,School of Psychology, The University of Queensland, St Lucia, Australia
| | - Sandy Huang
- School of Medicine, The University of Queensland, St Lucia, Australia
| | - Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.,School of Psychology, The University of Queensland, St Lucia, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
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16
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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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17
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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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18
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Xie Z, Ruan J, Jiang Y, Zhang B, Chen T, Luo J, Li D. Potential Impact of FDA Flavor Enforcement Policy on Vaping Behavior on Twitter. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12836. [PMID: 36232136 PMCID: PMC9565006 DOI: 10.3390/ijerph191912836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/28/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
In January 2020, the FDA announced an electronic cigarette (e-cigarette) flavor enforcement policy to restrict the sale of all unauthorized cartridge-based flavored e-cigarettes except tobacco and menthol flavors, which was implemented on 6 February 2020. This study aimed to understand the potential influence of this policy on one vaping behavior change-quitting vaping-using Twitter data. Twitter posts (tweets) related to e-cigarettes were collected between June 2019 and October 2020 through a Twitter streaming API. Based on the geolocation and keywords related to quitting vaping, tweets mentioning quitting vaping from the US were filtered. The demographics (age and gender) of Twitter users who mentioned quitting vaping were further inferred using a deep learning algorithm (deepFace). The proportion of tweets and Twitter users mentioning quitting vaping were compared between before and after the announcement and implementation of the flavor policy. Compared to before the FDA flavor policy, the proportion of tweets (from 0.11% to 0.20% and 0.24%) and Twitter users (from 0.15% to 0.70% and 0.86%) mentioning quitting vaping were significantly higher after the announcement and implementation of the policy (p-value < 0.001). In addition, there was an increasing trend in the proportion of female and young adults (18-35 years old) mentioning quitting vaping on Twitter after the announcement and implementation of the policy compared to that before the policy. Our results showed that the FDA flavor enforcement policy did have a positive impact on quitting vaping on Twitter. Our study provides an initial evaluation of the potential influence of the FDA flavor enforcement policy on user vaping behavior.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jinlong Ruan
- Department of Computer Science, University of Rochester, Rochester, NY 14627, USA
| | - Yifan Jiang
- Department of Computer Science, University of Rochester, Rochester, NY 14627, USA
| | - Bokai Zhang
- Department of Computer Science, University of Rochester, Rochester, NY 14627, USA
| | - Tianlang Chen
- Department of Computer Science, University of Rochester, Rochester, NY 14627, USA
| | - Jiebo Luo
- Department of Computer Science, University of Rochester, Rochester, NY 14627, USA
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
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19
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Tang Q, Zhou R, Xie Z, Li D. Monitoring and Identifying Emerging E-cigarette Brands and Flavors on Twitter: Observational Study (Preprint). JMIR Form Res 2022; 6:e42241. [DOI: 10.2196/42241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/24/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
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20
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Galimov A, Vassey J, Galstyan E, Unger JB, Kirkpatrick MG, Allem JP. 'Ice' flavor-related discussions on Twitter: a content analysis (Preprint). J Med Internet Res 2022; 24:e41785. [DOI: 10.2196/41785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 11/10/2022] Open
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21
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Ezike NC, Ames Boykin A, Dobbs PD, Mai H, Primack BA. Exploring Factors That Predict Marketing of e-Cigarette Products on Twitter: Infodemiology Approach Using Time Series. JMIR INFODEMIOLOGY 2022; 2:e37412. [PMID: 37113447 PMCID: PMC9987194 DOI: 10.2196/37412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/04/2022] [Accepted: 06/17/2022] [Indexed: 04/29/2023]
Abstract
Background Electronic nicotine delivery systems (known as electronic cigarettes or e-cigarettes) increase risk for adverse health outcomes among naïve tobacco users, particularly youth and young adults. This vulnerable population is also at risk for exposed brand marketing and advertisement of e-cigarettes on social media. Understanding predictors of how e-cigarette manufacturers conduct social media advertising and marketing could benefit public health approaches to addressing e-cigarette use. Objective This study documents factors that predict changes in daily frequency of commercial tweets about e-cigarettes using time series modeling techniques. Methods We analyzed data on the daily frequency of commercial tweets about e-cigarettes collected between January 1, 2017, and December 31, 2020. We fit the data to an autoregressive integrated moving average (ARIMA) model and unobserved components model (UCM). Four measures assessed model prediction accuracy. Predictors in the UCM include days with events related to the US Food and Drug Administration (FDA), non-FDA-related events with significant importance such as academic or news announcements, weekday versus weekend, and the period when JUUL maintained an active Twitter account (ie, actively tweeting from their corporate Twitter account) versus when JUUL stopped tweeting. Results When the 2 statistical models were fit to the data, the results indicate that the UCM was the best modeling technique for our data. All 4 predictors included in the UCM were significant predictors of the daily frequency of commercial tweets about e-cigarettes. On average, brand advertisement and marketing of e-cigarettes on Twitter was higher by more than 150 advertisements on days with FDA-related events compared to days without FDA events. Similarly, more than 40 commercial tweets about e-cigarettes were, on average, recorded on days with important non-FDA events compared to days without such events. We also found that there were more commercial tweets about e-cigarettes on weekdays than on weekends and more commercial tweets when JUUL maintained an active Twitter account. Conclusions e-Cigarette companies promote their products on Twitter. Commercial tweets were significantly more likely to be posted on days with important FDA announcements, which may alter the narrative about information shared by the FDA. There remains a need for regulation of digital marketing of e-cigarette products in the United States.
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Affiliation(s)
- Nnamdi C Ezike
- College of Education and Health Professions University of Arkansas Fayetteville, AR United States
| | - Allison Ames Boykin
- College of Education and Health Professions University of Arkansas Fayetteville, AR United States
| | - Page D Dobbs
- College of Education and Health Professions University of Arkansas Fayetteville, AR United States
| | - Huy Mai
- College of Engineering University of Arkansas Fayetteville, AR United States
| | - Brian A Primack
- College of Public Health and Human Sciences Oregon State University Corvallis, OR United States
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22
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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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23
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Metcalf M, Rossie K, Stokes K, Tanner B. Health Care Professionals' Clinical Skills to Address Vaping and e-Cigarette Use by Patients: Needs and Interest Questionnaire Study. JMIR Form Res 2022; 6:e32242. [PMID: 35404264 PMCID: PMC9039806 DOI: 10.2196/32242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Widespread vaping and e-cigarette use is a relatively new phenomenon. Youth vaping peaked in 2019, with over 25% of high school students currently vaping. e-Cigarettes are used where smoking is not permitted or as an alternative smoking cessation treatment instead of Food and Drug Administration-approved options. Vaping and e-cigarette use has the potential to harm health, including causing adverse respiratory effects and nicotine addiction. Health care professionals need skills training to help their patients with this relatively new and evolving health problem. OBJECTIVE The aim of this study is to understand health care professionals' training needs in this subject area to determine the focus for web-based continuing education training. METHODS We reviewed the literature on clinical aspects of vaping and e-cigarette use. Using the results and our experience in substance use continuing education, we created a list of key clinical skills and surveyed health care professionals about their training needs. We also asked about their interest in a list of related topics. We recruited individuals who completed our web-based courses on substance use, members of health care professional-related groups, and experts who had published an article on the subject. Half of the 31 health care professionals who completed the survey were physicians and the remainder were primarily nurses, social workers, and counselors. Participants self-identified as nonexperts (n=25) and experts (n=6) on vaping. RESULTS Participants who were nonexperts on average agreed or strongly agreed that they needed training in each of 8 clinical skills (n=25; range 3.7-4.4 agreement out of 5). The top two skills were recommending treatments for patients (4.4 out of 5, SD 0.49) and evaluating and treating the health effects of vaping and e-cigarette use (4.4 out of 5, SD 0.50). Experts agreed on the importance of training for health care professionals in all skills but rated the need for training higher than nonexperts for each topic. Over half of the participating health care professionals (44%-80%) were interested in nearly all (9/10, 90%) vaping-related topics on a checklist. The topics participants were most interested in were the pros and cons of vaping versus smoking and the health effects of second- and third-hand vaping. Primary care physicians showed more interest in vaping-related topics than nonprimary care physicians (t13=2.17; P=.02). CONCLUSIONS This study confirmed gaps in health care professionals' vaping-related clinical skills identified in the literature by identifying a perceived need for training in related skills and health care professionals' interest in key topics related to vaping prevention and cessation. This study provides specific guidance on which clinical skills training is most needed and which topics are most interesting to health care professionals.
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Affiliation(s)
- Mary Metcalf
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Karen Rossie
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Katie Stokes
- Clinical Tools, Inc, Chapel Hill, NC, United States
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24
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Chu KH, Hershey TB, Hoffman BL, Wolynn R, Colditz JB, Sidani JE, Primack BA. Puff Bars, Tobacco Policy Evasion, and Nicotine Dependence: Content Analysis of Tweets. J Med Internet Res 2022; 24:e27894. [PMID: 35333188 PMCID: PMC8994141 DOI: 10.2196/27894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/13/2021] [Accepted: 02/03/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Puff Bars are e-cigarettes that continued marketing flavored products by exploiting the US Food and Drug Administration exemption for disposable devices. OBJECTIVE This study aimed to examine discussions related to Puff Bar on Twitter to identify tobacco regulation and policy themes as well as unanticipated outcomes of regulatory loopholes. METHODS Of 8519 original tweets related to Puff Bar collected from July 13, 2020, to August 13, 2020, a random 20% subsample (n=2661) was selected for qualitative coding of topics related to nicotine dependence and tobacco policy. RESULTS Of the human-coded tweets, 2123 (80.2%) were coded as relevant to Puff Bar as the main topic. Of those tweets, 698 (32.9%) discussed tobacco policy, including flavors (n=320, 45.9%), regulations (n=124, 17.8%), purchases (n=117, 16.8%), and other products (n=110, 15.8%). Approximately 22% (n=480) of the tweets referenced dependence, including lack of access (n=273, 56.9%), appetite suppression (n=59, 12.3%), frequent use (n=47, 9.8%), and self-reported dependence (n=110, 22.9%). CONCLUSIONS This study adds to the growing evidence base that the US Food and Drug Administration ban of e-cigarette flavors did not reduce interest, but rather shifted the discussion to brands utilizing a loophole that allowed flavored products to continue to be sold in disposable devices. Until comprehensive tobacco policy legislation is developed, new products or loopholes will continue to supply nicotine demand.
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Affiliation(s)
- Kar-Hai Chu
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tina B Hershey
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Beth L Hoffman
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Riley Wolynn
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jason B Colditz
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jaime E Sidani
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian A Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
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25
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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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26
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Jun J, Zhang N, Zain A, Mohammadi E. Social Media Discussions on the FDA's Modified Risk Tobacco Product Authorization of IQOS. Subst Use Misuse 2022; 57:472-480. [PMID: 34986075 DOI: 10.1080/10826084.2021.2019777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: The U.S. Food and Drug Administration (FDA) authorized the marketing of the IQOS tobacco heating system as a modified risk tobacco product (MRTP) in July 2020, permitting its 'reduced exposure' marketing. This decision is accompanied by much controversy among the global health community. We provide a preliminary analysis of Twitter conversations regarding the MRTP authorization of IQOS by identifying the authors, valence towards the policy decision, source of cited link, and focused topic. Methods: We analyzed 548 tweets mentioning MRTP posted between July 2016 (when PMI submitted the proposal) and October 2020. Results: We found a higher proportion of pro-MRTP valence (25.4%) than anti-MRTP (16.2%). Nearly half of the tweets (47.2%) expressing personal opinions presented pro-MRTP valence (vs. anti-MRTP = 23.9%). The FDA website was more frequently cited in pro-MRTP tweets (30.8% vs. anti = 4.8%), while tobacco control advocates' websites were cited only in anti-MRTP tweets (77.4% vs. pro = 0). Pro-MRTP valence appeared more frequently in tweets mentioning health (53.1% vs. anti =38.5%) and cessation (100% vs. anti = 0). Nearly 42% of tweets showed a bot score greater than .43, indicating a possibility of automation. Conclusion: Continuous efforts are needed to surveil the industry's attempts to create a climate of false consensus and circulate misinformation regarding MRTP on social media, as well as to assist non-scientific audiences' understanding of MRTP.
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Affiliation(s)
- Jungmi Jun
- School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina, Columbia, South Carolina, USA
| | - Nanlan Zhang
- School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina, Columbia, South Carolina, USA
| | - Ali Zain
- School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina, Columbia, South Carolina, USA
| | - Ehsan Mohammadi
- School of Information Science, College of Information and Communications, University of South Carolina, Columbia, South Carolina, USA
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27
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Esquer C, Echeagaray O, Firouzi F, Savko C, Shain G, Bose P, Rieder A, Rokaw S, Witon-Paulo A, Gude N, Sussman MA. Fundamentals of vaping-associated pulmonary injury leading to severe respiratory distress. Life Sci Alliance 2021; 5:5/2/e202101246. [PMID: 34810278 PMCID: PMC8616545 DOI: 10.26508/lsa.202101246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/29/2022] Open
Abstract
Vaping of flavored liquids has been touted as safe alternative to traditional cigarette smoking with decreased health risks. The popularity of vaping has dramatically increased over the last decade, particularly among teenagers who incorporate vaping into their daily life as a social activity. Despite widespread and increasing adoption of vaping among young adults, there is little information on long-term consequences of vaping and potential health risks. This study demonstrates vaping-induced pulmonary injury using commercial JUUL pens with flavored vape juice using an inhalation exposure murine model. Profound pathological changes to upper airway, lung tissue architecture, and cellular structure are evident within 9 wk of exposure. Marked histologic changes include increased parenchyma tissue density, cellular infiltrates proximal to airway passages, alveolar rarefaction, increased collagen deposition, and bronchial thickening with elastin fiber disruption. Transcriptional reprogramming includes significant changes to gene families coding for xenobiotic response, glycerolipid metabolic processes, and oxidative stress. Cardiac systemic output is moderately but significantly impaired with pulmonary side ventricular chamber enlargement. This vaping-induced pulmonary injury model demonstrates mechanistic underpinnings of vaping-related pathologic injury.
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Affiliation(s)
- Carolina Esquer
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Oscar Echeagaray
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Fareheh Firouzi
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Clarissa Savko
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Grant Shain
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Pria Bose
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Abigail Rieder
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Sophie Rokaw
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Andrea Witon-Paulo
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Natalie Gude
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
| | - Mark A Sussman
- San Diego State University Integrated Regenerative Research Institute and Biology Department, San Diego State University, San Diego, CA, USA
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28
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Basch CH, Fera J, Pellicane A, Basch CE. Videos With the Hashtag #vaping on TikTok and Implications for Informed Decision-making by Adolescents: Descriptive Study. JMIR Pediatr Parent 2021; 4:e30681. [PMID: 34694231 PMCID: PMC8576590 DOI: 10.2196/30681] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/29/2021] [Accepted: 09/06/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Despite the public health importance of vaping and the widespread use of TikTok by adolescents and young adults, research is lacking on the nature and scope of vaping content on this networking service. OBJECTIVE The purpose of this study is to describe the content of TikTok videos related to vaping. METHODS By searching the hashtag #vaping in the discover feature, ~478.4 million views were seen during the time of data collection. The first 100 relevant videos under that hashtag were used in this study. Relevance was determined by simply noting if the video was related in any way to vaping. Coding consisted of several categories directly related to vaping and additional categories, including the number of likes, comments, and views, and if the video involved music, humor, or dance. RESULTS The 100 videos included in the sample garnered 156,331,347 views; 20,335,800 likes; and 296,460 comments. The majority of the videos (n=59) used music and over one-third (n=37) used humor. The only content category observed in the majority of the videos sampled was the promotion of vaping, which was included in 57 videos that garnered over 74 million views (47.5% of cumulative views). A total of 42% (n=42) of the 100 videos sampled featured someone vaping or in the presence of vape pens, and these videos garnered over 22% (>35 million) of the total views. CONCLUSIONS It is necessary for public health agencies to improve understanding of the nature and content of videos that attract viewers' attention and harness the strength of this communication channel to promote informed decision-making about vaping.
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Affiliation(s)
- Corey H Basch
- William Paterson University, Wayne, NJ, United States
| | | | | | - Charles E Basch
- Teachers College, Columbia University, New York, NY, United States
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29
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Gao Y, Xie Z, Li D. Investigating the Impact of New York State Flavor Ban on E-cigarettes Discussion on Twitter: Observational Study (Preprint). JMIR Public Health Surveill 2021; 8:e34114. [PMID: 35802417 PMCID: PMC9308079 DOI: 10.2196/34114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/08/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background On May 18, 2020, the New York State Department of Health implemented a statewide flavor ban to prohibit the sales of all flavored vapor products, except for tobacco or any other authorized flavor. Objective This study aims to investigate the discussion changes in e-cigarette–related tweets over time with the implementation of the New York State flavor ban. Methods Through the Twitter streaming application programming interface, 59,883 e-cigarette–related tweets were collected within the New York State from February 6, 2020, to May 17, 2020 (period 1, before the implementation of the flavor ban), May 18, 2020-June 30, 2020 (period 2, between the implementation of the flavor ban and the online sales ban), July 1, 2020-September 15, 2020 (period 3, the short term after the online sales ban), and September 16, 2020-November 30, 2020 (period 4, the long term after the online sales ban). Sentiment analysis and topic modeling were conducted to investigate the changes in public attitudes and discussions in e-cigarette–related tweets. The popularity of different e-cigarette flavor categories was compared before and after the implementation of the New York State flavor ban. Results Our results showed that the proportion of e-cigarette–related tweets with negative sentiment significantly decreased (4305/13,246, 32.5% vs 3855/14,455, 26.67%, P<.001), and tweets with positive sentiment significantly increased (5246/13,246, 39.6% vs 7038/14,455, 48.69%, P<.001) in period 4 compared to period 3. “Teens and nicotine products” was the most frequently discussed e-cigarette–related topic in the negative tweets. In contrast, “nicotine products and quitting” was more prevalent in positive tweets. The proportion of tweets mentioning mint and menthol flavors significantly increased right after the flavor ban and decreased to lower levels over time. The proportions of fruit and sweet flavors were most frequently mentioned in period 1, decreased in period 2, and dominated again in period 4. Conclusions The proportion of e-cigarette–related tweets with different attitudes and frequently discussed flavor categories changed over time after the implementation of the New York State ban of flavored vaping products. This change indicated a potential impact of the flavor ban on public discussions of flavored e-cigarettes.
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Affiliation(s)
- Yankun Gao
- University of Rochester Medical Center, Rochester, NY, United States
| | - Zidian Xie
- University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- University of Rochester Medical Center, Rochester, NY, United States
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30
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Sun T, Lim CCW, Gartner C, Connor JP, Hall WD, Leung J, Stjepanović D, Chan GCK. Reactions on Twitter towards Australia's proposed import restriction on nicotine vaping products: a thematic analysis. Aust N Z J Public Health 2021; 45:543-545. [PMID: 34411375 DOI: 10.1111/1753-6405.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/01/2021] [Accepted: 05/01/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE In June 2020, the Australian Government announced that personal importation of nicotine vaping products (NVP) would be prohibited, pending a 12-month classification and regulation review by the Therapeutic Goods Administration. This brief report examines the themes of responses on Twitter to this announcement. METHODS Simple random sampling was used to retrieve tweets containing keywords from 19 to 26 June 2020. Tweets were manually coded and descriptive statistics calculated for themes and policy position. RESULTS The vast majority of the 1,168 tweets were anti-policy. Themes included: criticism towards government (59.8%), activism against NVP restriction (38%), potential adverse consequences (30.8%) and support for NVP restriction (1.4%). Tweets that identified potential adverse consequences of NVP restriction cited: smoking relapse for individuals currently using NVPs (75.6%); the impact of policy enforcement (8.6%); illicit market (8.3%); panic buying (3.6%); difficulty obtaining prescriptions (2.8%); and impacts on NVP businesses (2.8%). CONCLUSION Tweets predominately objected to the policy announcement. Approximately three-quarters of tweets that cited potential adverse consequences of the policy mentioned smoking relapse as their primary concern. Implications for public health: User-generated content on Twitter was primarily used to lobby against the proposed policy, which was subsequently amended.
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Affiliation(s)
- Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland.,School of Psychology, The University of Queensland.,NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland
| | - Carmen C W Lim
- National Centre for Youth Substance Use Research, The University of Queensland.,School of Psychology, The University of Queensland
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland
| | - Jason P Connor
- National Centre for Youth Substance Use Research, The University of Queensland.,Discipline of Psychiatry, The University of Queensland
| | - Wayne D Hall
- National Centre for Youth Substance Use Research, The University of Queensland
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland.,School of Psychology, The University of Queensland.,National Drug and Alcohol Research Centre, University of New South Wales
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland
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31
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Bardier C, Yang JS, Li J, Mackey TK. Characterizing alternative and emerging tobacco product transition of use behavior on Twitter. BMC Res Notes 2021; 14:303. [PMID: 34372926 PMCID: PMC8351350 DOI: 10.1186/s13104-021-05719-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The objective of this study was to develop an inductive coding approach specific to characterizing user-generated social media conversations about transition of use of different tobacco and alternative and emerging tobacco products (ATPs). RESULTS A total of 40,206 tweets were collected from the Twitter public API stream that were geocoded from 2018 to 2019. Using data mining approaches, these tweets were then filtered for keywords associated with tobacco and ATP use behavior. This resulted in a subset of 5718 tweets, with 657 manually annotated and identified as associated with user-generated conversations about tobacco and ATP use behavior. The 657 tweets were coded into 9 parent codes: inquiry, interaction, observation, opinion, promote, reply, share knowledge, use characteristics, and transition of use behavior. The highest number of observations occurred under transition of use (43.38%, n = 285), followed by current use (39.27%, n = 258), opinions about use (0.07%, n = 46), and product promotion (0.06%, n = 37). Other codes had less than ten tweets that discussed these themes. Results provide early insights into how social media users discuss topics related to transition of use and their experiences with different and emerging tobacco product use behavior.
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Affiliation(s)
- Cortni Bardier
- Global Health Policy and Data Institute, San Diego, CA, USA
- Department of Anthropology, Global Health Program, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- S-3 Research LLC, San Diego, CA, USA
| | - Joshua S Yang
- Department of Public Health, California State University, Fullerton, Fullerton, CA, USA
| | - Jiawei Li
- Global Health Policy and Data Institute, San Diego, CA, USA
- S-3 Research LLC, San Diego, CA, USA
| | - Tim K Mackey
- Global Health Policy and Data Institute, San Diego, CA, USA.
- Department of Anthropology, Global Health Program, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
- S-3 Research LLC, San Diego, CA, USA.
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32
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Xie Z, Wang X, Gu Y, Li D. Exploratory Analysis of Electronic Cigarette-Related Videos on YouTube: Observational Study. Interact J Med Res 2021; 10:e27302. [PMID: 34255663 PMCID: PMC8292940 DOI: 10.2196/27302] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/03/2021] [Accepted: 06/02/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Electronic cigarette (e-cigarette) use has become more popular than cigarette smoking, especially among youth. Social media platforms, including YouTube, are a popular means of sharing information about e-cigarette use (vaping). OBJECTIVE This study aimed to characterize the content and user engagement of e-cigarette-related YouTube videos. METHODS The top 400 YouTube search videos related to e-cigarettes were collected in January 2020. Among them, 340 valid videos were classified into provaping, vaping-warning, and neutral categories by hand coding. Additionally, the content of e-cigarette videos and their user engagement (including average views and likes) were analyzed and compared. RESULTS While provaping videos were dominant among e-cigarette-related YouTube videos from 2007 to 2017, vaping-warning videos started to emerge in 2013 and became dominant between 2018 and 2019. Compared to vaping-warning videos, provaping videos had higher average daily views (1077 vs 822) but lower average daily likes (12 vs 15). Among 161 provaping videos, videos on user demonstration (n=100, 62.11%) were dominant, and videos on comparison with smoking had the highest user engagement (2522 average daily views and 28 average daily likes). Conversely, among 141 vaping-warning videos, videos on potential health risks were the most popular topic (n=57, 40.42%) with the highest user engagement (1609 average daily views and 33 average daily likes). CONCLUSIONS YouTube was dominated by provaping videos, with the majority of videos on user demonstrations before 2018. The vaping-warning videos became dominant between 2018 and 2019, with videos on potential health risks being the most popular topic. This study provides updated surveillance on e-cigarette-related YouTube videos and some important guidance on associated social media regulations.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Xueting Wang
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Yu Gu
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
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McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, Jancey J. "Is it banned? Is it illegal?": Navigating Western Australia's regulatory environment for e-cigarettes. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103177. [PMID: 33713966 DOI: 10.1016/j.drugpo.2021.103177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Australia, there is no Federal legislation that directly applies to e-cigarettes, instead, several existing laws relating to poisons, therapeutic goods and tobacco control apply. Across all Australian States and Territories, it is illegal to sell nicotine-containing e-cigarettes, however, users can legally import nicotine-containing vaporisers through the Personal Importation Scheme. Western Australia differs from other Australian States and Territories in that products which resemble tobacco products are banned, effectively prohibiting the use of e-cigarettes. This study aimed to understand how e-cigarette users navigate Western Australia's regulatory environment to access vaping products and the health and safety issues encountered. METHODS Working from a constructionist epistemology and a symbolic interaction framework, in-depth interviews were conducted with a purposive sample of 37 current (89%) and former (11%) adult vapers (70% male, mean age of 32.5). Data was analysed via thematic analysis. RESULTS Vape retailers were said to be circumventing Western Australia's e-cigarette restrictions by selling the components of 'open system' devices that do not resemble a tobacco product when sold individually. Participants were unsure of the legality of importing, accessing and using nicotine and e-cigarettes, however, the majority continued to use nicotine-containing vaporisers and implemented strategies in an attempt to avoid detection and safeguard their health. The internet facilitated access to desired products, information on health and safety, and discussions of personal experiences. CONCLUSIONS The Australian Therapeutic Goods Administration has recently (21 December 2020) confirmed that from 1 October 2021 smokers who have tried quitting with other approved cessation pharmacotherapies will be required to obtain a prescription for nicotine-containing vaporiser products from a registered medical practitioner. The results of this study suggest further consideration of regulatory measures are however required to support the different characteristics of vapers and to mitigate the health and safety concerns experienced by e-cigarette users.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia.
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Western Australia, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Bentley, Western Australia, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
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