A content analysis of e-cigarette marketing on social media: Findings from the Tobacco Enforcement and Reporting Movement (TERM) in India, Indonesia and Mexico

Exploring stroke discourse on Twitter through content and network analysis among Indian users

The study aimed to understand stroke-related Twitter conversations in India, focusing on topics, message sources, reach, and influential users to provide insights to stakeholders regarding community needs for knowledge, support, and interventions. Geo-tagged Twitter posts focusing on stroke originating from India and, spanning from November 7, 2022, to February 28, 2023, were systematically obtained via the Twitter application programming interface, using keywords and hashtags sourced through Symplur Signals. Preprocessing involved the removal of hashtags, stop words, and URLs. The Latent Dirichlet Allocation (LDA) topic model was used to identify recurring stroke-related topics, while influential users were identified through social network analysis. About half of the tweets about stroke in India were about seeking support and post-stroke bereavement sharing and had the highest reachability. Four out of 10 tweets were from the individual twitter users. Tweets on the topic risk factors, awareness and prevention (14.6%) constituted the least proportion, whereas the topic management, research, and promotion had the least retweet ratio. Twitter demonstrates significant potential as a platform for both disseminating and acquiring stroke-related information within the Indian context. The identified topics and understanding of the content of discussion offer valuable resources to public health professionals and organizations to develop targeted educational and engagement strategies for the relevant audience.

A qualitative exploration of e-cigarette prevention advertisements' effectiveness among college students in China

INTRODUCTION

The rapid growth of e-cigarette usage among youth and young people has emerged as a significant public health concern. It is imperative to initiate effective vaping prevention campaigns and undertake relevant research to address this pressing issue. This research seeks to identify effective video advertisements to deter young people from starting to use e-cigarettes. It aims to offer evidence-based insights and recommendations for creating communication materials and designing messages for youth e-cigarette prevention efforts.

METHODS

College students aged 18-24 years (n=40) participated in focus groups within this qualitative study. After viewing four stimulus videos, participants discussed what they perceived as effective and ineffective video characteristics, as well as suggestions for future videos.

RESULTS

Effective video characteristics included the use of real-life testimonials, displaying specific health hazards, revealing harmful chemical ingredients and the deceptive nature of flavors, and positively perceived effectiveness. Participants generally found that videos with strong visual impact and graphics were more engaging and that approaches using fear and emotion were more effective. Ineffective characteristics included complex and exaggerated information, lack of empathy and irrelevance, insufficiently specific information, extreme and death-themed content, industry messages, as well as preachy tones, animations, metaphors, dull formats, excessive length, and scenes of e-cigarette use.

CONCLUSIONS

Developing anti-e-cigarette campaign materials for youth necessitates target audience-focused qualitative research. This helps in deeply exploring and identifying effective themes and messages, as well as video characteristics and details while avoiding ineffective or even misleading messages and themes from young people's perspectives outside the United States. Future development of e-cigarette prevention videos for Chinese college students may consider incorporating localized real-life testimonial cases to convey specific harms, including self-efficacy information, and utilizing fear and emotional appeals.

Marketing claims, promotional strategies, and product information on Malaysian e-cigarette retailer websites-a content analysis

BACKGROUND

Marketing and sales of e-cigarettes are unregulated in Malaysia. We analyzed content displayed on e-cigarette retailer websites to identify marketing claims, promotional strategies, and product details in the year 2022.

METHODS

We analyzed 30 Malaysia-based retailer websites using a mixed methods approach. Data were extracted as the frequency of occurrences of marketing claims, presence of regulatory information, product types, and flavors of e-juice as per a predefined codebook based on published literature. We also extracted textual details published on the websites about marketing claims, and slogans.

RESULTS

Most retailer websites provided contact information and physical store addresses (83%) but only half had 'click through' age verification (57%) that seldom needed any identification proof for age (3%). Marketing claims were related to health (47%), smoking cessation (37%), and modernity/trend (37%) and none had health warnings. Promotional strategies were discounts (80%). starter kits (57%) and email subscriptions (53%). Product types displayed were rechargeable (97%) and disposable (87%) devices and e-liquids (90%) of an array of flavors (> 100). Nicotine presence, its concentration, and "nicotine is an addictive chemical" were displayed in 93%, 53%, and 23% of websites respectively.

CONCLUSION

Surveillance of content displayed online on e-cigarette retailer websites and regulation of online marketing and sales should be implemented by the Ministry of Health, Malaysia. Such measures are needed to prevent access to, and initiation of e-cigarette use among the youth and adults who do not smoke.

Tobacco, nicotine and counter-marketing promotions using Instagram's branded content tool

BACKGROUND

The social media conglomerate, Meta, has a policy prohibiting promotion of tobacco products, vaporisers, electronic cigarettes or other products that simulate smoking via their branded content tools. This study examines if branded Instagram posts comply with these self-regulatory efforts.

METHODS

We analysed the presence and content of tobacco/nicotine promotion, as well as counter-marketing, in a sample of 400 branded/paid partnership-labelled Instagram posts with tobacco/nicotine-related terms made between 31 July 2022 and 31 March 2023, gathered from Meta's CrowdTangle tool and classified by CrowdTangle as being in English.

RESULTS

Of the 217 active branded posts that mentioned or depicted tobacco/nicotine products, most promoted rather than countered the sale of such products (84.3% vs 15.7%, respectively). Posts originating from US Instagram users accounted for 42.6% of promotional content. After the USA, posts from Indonesia (19.1%), Pakistan (9.8%) and India (8.2%) were most frequent. Most posts were fully in English (74.9%). Posts featured hookah (39.4%), electronic nicotine delivery systems (ENDS) accessories (17.5%), ENDS devices and e-liquids (16.9%) and various types of cigars (15.3%). The majority of US posts promoted venues or events where tobacco/nicotine products were featured (71.8%). Almost half of all promotional posts (47.0%) were sponsored by tobacco industry accounts. Posts that encouraged cessation were primarily (47.1%) sponsored by non-government organisations.

CONCLUSION

Despite attempts at self-regulation, paid partnership posts promoting tobacco and nicotine products are present on Instagram, especially posts promoting venues and events that feature tobacco and nicotine use. Self-regulation of this content shows limited success, suggesting a need for federal oversight and additional counter-marketing in social media settings.

Factors associated with e-cigarette use among vocational students: A cross-sectional multistage cluster survey, Thailand

INTRODUCTION

The use of e-cigarettes has steadily increased, and vocational students are one primary target of e-cigarette marketing. This cross-sectional survey research aimed to explore e-cigarette use and examine the factors associated with it.

METHODS

Multistage cluster random sampling was employed to select 1536 students in vocational education institutions. A self-administered questionnaire was used to collect the data from September to December 2019. Multinomial logistic regression analysis was used to obtain the adjusted odds ratio (AOR) to determine the associated factors of e-cigarette use.

RESULTS

Altogether, 28.7% of the subjects were currently e-cigarette users, 7.4% used e-cigarettes only, and 21.3% were dual users. Various factors were found to be significantly associated with e-cigarette use by 43.7%. Those consisted of sex (male) (AOR=2.183; 95% CI: 1.510-3.157), grade point average (GPA) of <2.5 (AOR=2.363; 95% CI: 1.502-3.717), having neutral attitudes toward e-cigarette use (AOR=2.676; 95% CI: 1.499-4.779) and positive attitudes toward e-cigarette use (AOR=4.171; 95% CI: 2.250-7.734), moderate level of perceived behavioral control on e-cigarette use (AOR=3.520; 95% CI: 2.287-5.418) and low level of perceived behavioral control on e-cigarettes use (AOR=4.959; 95% CI: 3.274-7.511), moderate price of e-cigarettes (AOR=1.436; 95% CI: 1.009-2.044), and e-cigarette use of their parents (AOR=1.827; 95% CI: 1.137-2.938), close friends (AOR=4.327; 95% CI: 2.954-6.338) and idols (AOR=4.604; 95% CI: 1.844-11.497).

CONCLUSIONS

Students should be encouraged to develop negative attitudes toward e-cigarette use and increase their self-confidence to control the use of e-cigarettes. This can be achieved by regularly distributing information on the product's risks. Moreover, students can find inspiration and guidance from peers, close friends, or their idols, who will act as positive role models and inspire them not to initiate e-cigarette use.

Implications of nicotine vaping products for tobacco control in ASEAN low-income and middle-income countries: in-depth interviews with experts from the region

OBJECTIVES

The use of nicotine vaping products (NVPs) has increased in low-income and middle-income countries (LMICs) in the Association of Southeast Asian Nations (ASEAN) region; however, it is uncertain what implications the presence and use of NVPs have for tobacco control.

DESIGN

In-depth interviews were conducted to explore ASEAN tobacco control experts' (n=11) views on the rise of NVP use in ASEAN LMICs, current NVP policies, the potential harm reduction and smoking cessation utilities of these devices, and what implications they may have for tobacco control. Data were analysed using inductive, reflexive thematic analysis.

RESULTS

Five themes emerged: (1) NVPs threaten tobacco control in ASEAN LMICs; (2) commercial factors influence youth appeal and access: product attributes, marketing, supply chains; (3) opposition to the smoking cessation and harm reduction utilities of NVPs; (4) policies are inconsistent and fragmented in the region; and (5) tobacco industry power and tactics have been used to capture NVP markets.

CONCLUSIONS

ASEAN tobacco control experts believe that NVPs pose a threat to youth and non-smokers in LMICs in the region, largely because of tobacco industry NVP marketing activities. They do not support the use of NVPs for smoking cessation or harm reduction and call for more restrictions and consistent policy enforcement across the region to protect young people, while also cautiously recognising that use of NVPs may have some benefits for smokers.

Vaping Among Adolescents: An Overview of E-Cigarette Use in Middle and High School Students in India

E-cigarette use among middle and high school students has become a growing public health concern in recent years. The prevalence of e-cigarette use among adolescents has increased dramatically, and there are serious health risks associated with this behavior. This review article provides an overview of e-cigarette use in middle and high school students, including the prevalence of use, contributing factors, health effects, policies and regulations surrounding e-cigarette use in schools, and interventions for preventing e-cigarette use in adolescents. The article highlights the need for effective prevention and cessation programs, increased public awareness about the risks of e-cigarette use, and stronger regulations on e-cigarette products. Addressing e-cigarette use among youth is critical for protecting the health and well-being of future generations, and it is important for parents, educators, healthcare providers, and policymakers to work together to prevent and reduce e-cigarette use among adolescents and promote healthy behaviors.