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Jung S, Murthy D, Bateineh BS, Loukas A, Wilkinson AV. The Normalization of Vaping on TikTok Using Computer Vision, Natural Language Processing, and Qualitative Thematic Analysis: Mixed Methods Study. J Med Internet Res 2024; 26:e55591. [PMID: 39259963 PMCID: PMC11425021 DOI: 10.2196/55591] [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: 12/18/2023] [Revised: 04/07/2024] [Accepted: 05/20/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Social media posts that portray vaping in positive social contexts shape people's perceptions and serve to normalize vaping. Despite restrictions on depicting or promoting controlled substances, vape-related content is easily accessible on TikTok. There is a need to understand strategies used in promoting vaping on TikTok, especially among susceptible youth audiences. OBJECTIVE This study seeks to comprehensively describe direct (ie, explicit promotional efforts) and indirect (ie, subtler strategies) themes promoting vaping on TikTok using a mixture of computational and qualitative thematic analyses of social media posts. In addition, we aim to describe how these themes might play a role in normalizing vaping behavior on TikTok for youth audiences, thereby informing public health communication and regulatory policies regarding vaping endorsements on TikTok. METHODS We collected 14,002 unique TikTok posts using 50 vape-related hashtags (eg, #vapetok and #boxmod). Using the k-means unsupervised machine learning algorithm, we identified clusters and then categorized posts qualitatively based on themes. Next, we organized all videos from the posts thematically and extracted the visual features of each theme using 3 machine learning-based model architectures: residual network (ResNet) with 50 layers (ResNet50), Visual Geometry Group model with 16 layers, and vision transformer. We chose the best-performing model, ResNet50, to thoroughly analyze the image clustering output. To assess clustering accuracy, we examined 4.01% (441/10,990) of the samples from each video cluster. Finally, we randomly selected 50 videos (5% of the total videos) from each theme, which were qualitatively coded and compared with the machine-derived classification for validation. RESULTS We successfully identified 5 major themes from the TikTok posts. Vape product marketing (1160/10,990, 8.28%) reflected direct marketing, while the other 4 themes reflected indirect marketing: TikTok influencer (3775/14,002, 26.96%), general vape (2741/14,002, 19.58%), vape brands (2042/14,002, 14.58%), and vaping cessation (1272/14,002, 9.08%). The ResNet50 model successfully classified clusters based on image features, achieving an average F1-score of 0.97, the highest among the 3 models. Qualitative content analyses indicated that vaping was depicted as a normal, routine part of daily life, with TikTok influencers subtly incorporating vaping into popular culture (eg, gaming, skateboarding, and tattooing) and social practices (eg, shopping sprees, driving, and grocery shopping). CONCLUSIONS The results from both computational and qualitative analyses of text and visual data reveal that vaping is normalized on TikTok. Our identified themes underscore how everyday conversations, promotional content, and the influence of popular figures collectively contribute to depicting vaping as a normal and accepted aspect of daily life on TikTok. Our study provides valuable insights for regulatory policies and public health initiatives aimed at tackling the normalization of vaping on social media platforms.
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Affiliation(s)
- Sungwon Jung
- School of Journalism and Media, University of Texas at Austin, Austin, TX, United States
| | - Dhiraj Murthy
- School of Journalism and Media, University of Texas at Austin, Austin, TX, United States
| | - Bara S Bateineh
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
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Barrientos SA, Dabroy D, Ebrahimi Kalan M, Laestadius LI, Ben Taleb Z. Tobacco and Nicotine Products Adverse Health Events: Findings From the FDA Safety Reporting Portal. Tob Use Insights 2024; 17:1179173X241279674. [PMID: 39220628 PMCID: PMC11363042 DOI: 10.1177/1179173x241279674] [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: 03/25/2024] [Revised: 08/06/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction The FDA oversees regulatory aspects of all U.S. tobacco products. Understanding the impact of emerging health trends and incidents associated with various tobacco and nicotine products is vital for public health. This study utilizes the FDA's Tobacco Product Problem Reports (TPPRs) to characterize and track adverse health events (AHEs) associated with tobacco and nicotine products over time, considering the impact of EVALI and the COVID-19 pandemic. Methods FDA TPPRs from 2017-2022 provided information on AHEs related to various tobacco products. After data cleaning, 839 reports were categorized by two independent coders based on affected health category, frequency of AHEs reports, and proportion of AHEs per each health category. Additionally, variations in AHEs over time were assessed, considering major health events like EVALI and the COVID-19 pandemic. Results Among the 839 reports, electronic cigarettes (e-cigarettes) were the primary product of concern, comprising 90.6% (n = 760) of all reports, surpassing traditional cigarettes (5.1%; n = 43) and other products. Notably, 45.6% of reports (n = 383) identified the neurological system as the most frequently mentioned health category, each reporting at least one AHE. This was followed by the respiratory (39.1%; n = 328) and digestive (10.7%; n = 90) systems. Among all reported AHEs, respiratory system issues were most frequent (25.9%; n = 512), closely followed by neurological (25.2%; n = 499) and digestive (6.6%; n = 131) concerns. Most reports occurred in 2019 (65.7%; n = 551), coinciding with the EVALI outbreak, with a subsequent decline post-Q3 2019, highlighting the potential impact of specific health crises on reporting trends. Conclusion E-cigarettes dominated adverse health reports, particularly affecting the neurological and respiratory systems, with a peak in 2019. Our findings provide insights to regulatory entities and future research, enhancing understanding of AHEs in lesser-explored bodily systems, such as the neurological and digestive systems. This study emphasizes the need for ongoing and improved surveillance of emerging tobacco products to protect public health.
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Affiliation(s)
- Steven Alec Barrientos
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | - Danny Dabroy
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Linnea Irina Laestadius
- Joseph J. Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
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Guégan E, Zenone M, Mialon M, Gallopel-Morvan K. #Bartender: portrayals of popular alcohol influencer's videos on TikTok ©. BMC Public Health 2024; 24:1384. [PMID: 38783213 PMCID: PMC11112761 DOI: 10.1186/s12889-024-18571-1] [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: 10/05/2023] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Despite widespread use of the short-video social media platform TikTok©, limited research investigates how alcohol is portrayed on the platform. Previous research suggests that a driver of alcohol content on TikTok©, in part, comes from bartenders demonstrating how to make drinks. This study aims to explore the characterizing patterns of how bartender influencers on TikTok© feature and incorporate alcohol in their videos. METHODS We identified the global top 15 most followed bartenders on TikTok© in 2021 (cumulative 29.7 million subscribers) and the videos they posted in November and December 2021, the period just before Christmas and New Year, when alcohol tends to be more marketed than in other periods. The videos were coded based on five criteria: (1) the presence of alcohol or not; (2) alcohol categories; (3); alcohol brand(s) if visible; (4) the presence of candies and other sweet products; (5) presence of cues that refer to young people's interests. RESULTS In total, we identified 345 videos, which received 270,325,600 views in total, with an average of 18,021,707 views per video. Among these 345 videos, 92% (n = 317) displayed alcohol in their cocktail recipes (249,275,600 views, with an average of 786,358 views). The most common types of alcohol present in videos were liquor, vodka, rum, and whiskey, all of which are high-ABV beverages. 73% (n = 230) displayed or mentioned an alcohol brand. 17% (n = 55) associated alcohol with sweet products such as different types of candy (53,957,900 views, with an average of 981,053 views per video). 13% (n = 43) contained cues appealing to young people (e.g., cartoons, characters) (15,763,300 views, with an average of 366,588 views per video). CONCLUSIONS Our findings suggest a large presence of positively framed alcohol content posted by popular bartenders on TikTok©. As exposure to digital marketing is related to an increase in alcohol consumption, particularly among young people, regulations are needed to protect the public from alcohol-related harms.
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Affiliation(s)
- Erell Guégan
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes, France
| | - Marco Zenone
- Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Mélissa Mialon
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes, France.
- Trinity Business School, Trinity College Dublin, Dublin, Ireland.
| | - Karine Gallopel-Morvan
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes, France
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Lewis J, Melendez-Torres GJ. Prep-Tok: a queer critical discourse analysis of TikToks regarding HIV-related pre-exposure prophylaxis. CULTURE, HEALTH & SEXUALITY 2024; 26:449-465. [PMID: 37435990 DOI: 10.1080/13691058.2023.2224414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/08/2023] [Indexed: 07/13/2023]
Abstract
Human immunodeficiency virus (HIV) continues to present a public health problem, and pre-exposure prophylaxis (PrEP) offers a promising preventative intervention; however, its uptake remains low, so investigating determinants of use is essential. This article applies queer critical discourse analysis to a corpus of 121 TikToks sampled via the TikTok algorithm, coded and refined into three overarching content categories: 'what makes a PrEP user?', 'what is PrEP as a drug?', and 'sexual health and HIV'. Examples from within these categories reveal four underlying discursive themes: (1) stigmatisation of HIV as a 'gay disease' with a poor prognosis; (2) stigmatisation of gay men as unsafe, high-risk and untrustworthy; (3) stigmatisation of PrEP as increasing 'unsafe' sexual practices; (4) poor healthcare and education gay men and other beneficiaries of PrEP. These themes are influenced by a broad spectrum of homophobic and heteronormative discourses available with specific examples reflecting parts of this spectrum from predominantly perpetuating to occasionally challenging. The findings report complementary evidence obtained from other media platforms yet offer a unique take while suggesting useful avenues for future public health messaging relating to PrEP which may be used to inform the next steps against HIV.
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Affiliation(s)
- Joseph Lewis
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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Sert S. Temporary prolongation of the QT interval in acute ebastine intoxication due to challenge video on TikTok in a girl. Cardiol Young 2023; 33:1213-1216. [PMID: 36475309 DOI: 10.1017/s1047951122003717] [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: 12/12/2022]
Abstract
Antihistamines are among the most widely used medications in the world. Ebastine is an antihistaminic which is long-acting, second-generation, and selective H1-receptor inverse agonist. I report a twelve-year-and-six-month-old girl with temporary prolongation of the QTc interval caused by acute ebastine intoxication due to TikTok challenge. Initial electrocardiogram showed sinus arrhythmia (72 beats/min) and prolongation of the QTc interval (QTc 482 milliseconds). Gastric lavage was performed. Intravenous fluid was administered, and activated charcoal (1 g/kg/per dose) was given. Electrocardiogram 9 h after drug ingestion showed sinus rhythm and normal QTc interval (QTc 414milliseconds). During follow-up, no electrocardiogram abnormalities were detected with electrocardiogram monitoring. She was discharged on day 2 without any complications. This case report is the first in the literature to show acute intoxication with ebastine due to challenge video on TikTok, which leads to a temporary prolongation of the QTc interval. Also, with this case report, I assert the fact that it is important to properly supervise the use of social media, such as TikTok and to review the content of TikTok videos.
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Affiliation(s)
- Sadiye Sert
- Department of Paediatrics, Konya Beyhekim Training and Research Hospital, Konya, Turkey
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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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Gu L, Gao X, Li Y. What drives me to use TikTok: A latent profile analysis of users' motives. Front Psychol 2022; 13:992824. [PMID: 36532978 PMCID: PMC9752051 DOI: 10.3389/fpsyg.2022.992824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2023] Open
Abstract
With TikTok rising in social media, the heterogeneity of users creates diversity in motives for using it. The issue of which profiles of TikTok use motives can be identified warrants greater understanding. Conducting latent profile analyses for a sample of 384 TikTok users, we identified four profiles, namely overall low motives, overall medium motives, overall high motives, and escapist addiction and novelty motives profiles. The former three profiles reflect different levels of motivations across four motives (socially rewarding self-presentation, trendiness, escapist addiction, and novelty). It is worth noting that TikTok users in the escapist addiction and novelty motives profile are mainly motivated by escapist addiction and novelty, but not socially rewarding self-presentation or trendiness motives. Through multivariate analysis of variance (MANOVA) and multinomial logistic regression, we further explore the differences in TikTok use between the profiles and the extent to which users' background characteristics and TikTok use predict their profile membership. The four profiles differ significantly in terms of the scores of almost all TikTok use motives. The frequency of TikTok use and video posting are the most notable predictors of profile membership. These results make theoretical contributions to the extant literature on social media use profiles by exploring the number and types of latent profiles of TikTok use motives, which also inform opportunities for enhancing user experience and imply tailored content recommendations to both achieve maximized gratifications and maintain mental wellbeing based on user profiles.
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Affiliation(s)
| | | | - Yong Li
- School of Innovation Design, Guangzhou Academy of Fine Arts, Guangzhou, China
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McMann TJ, Calac A, Nali M, Cuomo R, Maroulis J, Mackey TK. Synthetic Cannabinoids in Prisons: Content Analysis of TikToks. JMIR INFODEMIOLOGY 2022; 2:e37632. [PMID: 37113804 PMCID: PMC9987188 DOI: 10.2196/37632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 04/29/2023]
Abstract
Background Synthetic cannabinoids are a significant public health concern, especially among incarcerated populations due to increased reports of abuse. Recent news reports have highlighted the severe consequences of K2/Spice, a synthetic cannabinoid, among the prison population in the United States. Despite regulations against cell phone use, inmates use TikTok to post K2/Spice-related content. Objective This study aimed to examine TikTok posts for use and illicit distribution of psychoactive substances (eg, K2/Spice) among incarcerated populations. Methods The study collected TikTok videos associated with the #k2spice hashtag and used a data collection approach similar to snowball sampling. Inductive coding was used to conduct content analysis of video characteristics. Videos were manually annotated to generate binary classifications related to the use of K2/Spice as well as selling and buying activities associated with it. Statistical analysis was used to determine associations between a video's user engagement and an intent to buy or sell K2/Spice. Results A total of 89 TikTok videos with the hashtag #k2spice were manually coded, with 40% (n=36) identified as displaying the use, solicitation, or adverse effects of K2/Spice among the prison population. Of them, 44.44% (n=16) were in a prison-based setting documenting adverse effects including possible overdose. Videos with higher user engagement were positively correlated with comments indicating an intent to buy or sell K2/Spice. Conclusions K2/Spice is a drug subject to abuse among prison inmates in the United States, including depictions of its harmful effects being recorded and shared on TikTok. Lack of policy enforcement on TikTok and the need for better access to treatment services within the prison system may be exacerbating substance use among this highly vulnerable population. Minimizing the potential individual harm of this content on the incarcerated population should be a priority for social media platforms and the criminal justice system alike.
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Affiliation(s)
- Tiana J McMann
- Global Health Program Department of Anthropology University of California San Diego La Jolla, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- S-3 Research San Diego, CA United States
| | - Alec Calac
- Global Health Policy and Data Institute San Diego, CA United States
- Department of Anesthesiology University of California San Diego San Diego, CA United States
| | - Matthew Nali
- Global Health Policy and Data Institute San Diego, CA United States
- S-3 Research San Diego, CA United States
| | - Raphael Cuomo
- Global Health Policy and Data Institute San Diego, CA United States
- Department of Anesthesiology University of California San Diego San Diego, CA United States
| | - James Maroulis
- Global Health Policy and Data Institute San Diego, CA United States
| | - Tim K Mackey
- Global Health Program Department of Anthropology University of California San Diego La Jolla, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- S-3 Research San Diego, CA United States
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