Smokers’ Likelihood to Engage With Information and Misinformation on Twitter About the Relative Harms of e-Cigarette Use: Results From a Randomized Controlled Trial (original) (raw)
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BMJ Open, 2021
ObjectivesTo assess the effect of exposure to misinformation about e-cigarette harms found on Twitter on adult current smokers’ intention to quit smoking cigarettes, intention to purchase e-cigarettes and perceived relative harm of e-cigarettes compared with regular cigarettes.SettingAn online randomised controlled experiment conducted in November 2019 among USA and UK current smokers.Participants2400 adult current smokers aged ≥18 years who were not current e-cigarette users recruited from an online panel. Participants’ were randomised in a 1:1:1:1 ratio using a least-fill randomiser function.InterventionsViewing 4 tweets in random order within one of four conditions: (1) e-cigarettes are just as or more harmful than smoking, (2) e-cigarettes are completely harmless, (3) e-cigarette harms are uncertain, and (4) a control condition of tweets about physical activity.Primary outcomes measuresSelf-reported post-test intention to quit smoking cigarettes, intention to purchase e-cigarett...
International Journal of Environmental Research and Public Health, 2021
There is a gap in knowledge on the affective mechanisms underlying effects of exposure to health misinformation. This study aimed to understand whether discrete emotional responses and perceived relative harm of e-cigarettes versus smoking mediate the effect of exposure to tweets about the harms of e-cigarettes on Twitter and intention to purchase e-cigarettes among adult smokers. We conducted a web-based experiment in November 2019 among 2400 adult smokers who were randomly assigned to view one of four conditions of tweets containing different levels of misinformation. We fitted mediation models using structural equation modeling and bootstrap procedures to assess the indirect effects of exposure to tweets through perceived relative harm of e-cigarettes and six discrete emotions. Our findings support that exposure to tweets about harms of e-cigarettes influence intention to purchase e-cigarettes through perceived relative harm, discrete emotional responses, and serially through emo...
Journal of Medical Internet Research
Background: There has been a rapid rise in the popularity of electronic cigarettes (e-cigarettes) over the last decade, with growth predicted to continue. The uptake of these devices has escalated despite inconclusive evidence of their efficacy as a smoking cessation device and unknown long-term health consequences. As smoking rates continue to drop or plateau in many well-developed countries, transnational tobacco companies have transitioned into the vaping industry and are now using social media to promote their products. Evidence indicates e-cigarettes are being marketed on social media as a harm reduction alternative, with retailers and manufacturers utilizing marketing techniques historically used by the tobacco industry. Objective: This study aimed to identify and describe the messages presented in e-cigarette-related social media (Twitter, YouTube, Instagram, and Pinterest) promotions and discussions and identify future directions for research, surveillance, and regulation. Methods: Data sources included MEDLINE, Scopus, ProQuest, Informit, the Journal of Medical Internet Research, and Google Scholar. Included studies were published in English between 2007 and 2017, analyzed content captured from e-cigarette-related social media promotions or discussions, and reported results for e-cigarettes separately from other forms of tobacco and nicotine delivery. Database search ceased in October 2017. Initial searches identified 536 studies. Two reviewers screened studies by title and abstract. One reviewer examined 71 full-text articles to determine eligibility and identified 25 studies for inclusion. This process was undertaken with the assistance of the Web-based screening and data extraction tool-Covidence. The review was registered with the Joanna Briggs Institute (JBI) Systematic Reviews database and followed the methodology for JBI Scoping Reviews. Results: Several key messages are being used to promote e-cigarettes including as a safer alternative to cigarettes, efficacy as a smoking cessation aid, and for use where smoking is prohibited. Other major marketing efforts aimed at capturing a larger market involve promotion of innovative flavoring and highlighting the public performance of vaping. Discussion and promotion of these devices appear to be predominantly occurring among the general public and those with vested interests such as retailers and manufacturers. There is a noticeable silence from the public health and government sector in these discussions on social media. Conclusions: The social media landscape is dominated by pro-vaping messages disseminated by the vaping industry and vaping proponents. The uncertainty surrounding e-cigarette regulation expressed within the public health field appears not to be reflected in ongoing social media dialogues and highlights the need for public health professionals to interact with the public to actively influence social media conversations and create a more balanced discussion. With the vaping industry changing so rapidly, real-time monitoring and surveillance of how these devices are discussed, promoted, and used on social media is necessary in conjunction with evidence published in academic journals.
A cross-sectional examination of marketing of electronic cigarettes on Twitter
Tobacco Control, 2014
Background Rapid increases in marketing of e-cigarettes coincide with growth in e-cigarette use in recent years; however, little is known about how e-cigarettes are marketed on social media platforms. Methods Keywords were used to collect tweets related to e-cigarettes from the Twitter Firehose between 1 May 2012 and 30 June 2012. Tweets were coded for smoking cessation mentions, as well as health and safety mentions, and were classified as commercial or non-commercial ('organic') tweets using a combination of Naïve Bayes machine learning methods, keyword algorithms and human coding. Metadata associated with each tweet were used to examine the characteristics of accounts tweeting about e-cigarettes.
Contextualising the 2019 E-Cigarette Health Scare: Insights from Twitter
International Journal of Environmental Research and Public Health, 2020
A health scare can be described as a campaign that attempts to alert the public of a particular substance or activity that can lead to a negative effect on health. A recent health scare to emerge relates to the health hazards associated with the use of e-cigarettes, which has caused widespread debate, which peaked towards the end of 2019. Health scares need to be studied in the context in which they occur, and one method of studying them is through social media. This paper identifies two key topics of discussion on Twitter, which consisted of pro-vaping and anti-vaping views. The paper then identifies influential users, frequently occurring words, hashtags, and websites related to this time period in order to gain insight into e-cigarette perceptions. The paper then reviews current scientific evidence and develops a flowchart for the general public, which can be used to for public reassurance and guidance.
BACKGROUND There has been a rapid rise in the popularity of electronic cigarettes (e-cigarettes) over the last decade, with growth predicted to continue. The uptake of these devices has escalated despite inconclusive evidence of their efficacy as a smoking cessation device and unknown long-term health consequences. As smoking rates continue to drop or plateau in many well-developed countries, transnational tobacco companies have transitioned into the vaping industry and are now using social media to promote their products. Evidence indicates e-cigarettes are being marketed on social media as a harm reduction alternative, with retailers and manufacturers utilizing marketing techniques historically used by the tobacco industry. OBJECTIVE This study aimed to identify and describe the messages presented in e-cigarette–related social media (Twitter, YouTube, Instagram, and Pinterest) promotions and discussions and identify future directions for research, surveillance, and regulation. MET...
Addressing e-cigarette health claims made on social media amidst the COVID-19 pandemic
World Journal of Pediatrics, 2021
We are in a global pandemic that is responsible for more than 73.6 million confirmed cases and over 1.64 million deaths. Recent evidence highlights that electronic cigarette (e-cig) use by young people has a strong association with COVID-19 diagnosis [1]. The e-cig industry has successfully utilized social media platforms to market e-cigs to adolescents [2]. The industry typically posts on various social media sites, such as Instagram and Reddit, frequented by adolescents. Moreover, evidence [3] collected from social media during the COVID19 pandemic has shown that there have been various unsubstantiated health claims made about e-cigarettes (e-cigs) and its contents being protective factors against COVID19. Specifically, Majumdar et al. [3] conducted surveillance on Twitter regarding conversations on the topic of e-cigs. Three main health claims were found in their study, these themes perpetuate that e-cigs can prevent COVID-19 infections by increasing the humidity in the lungs, e-...
Journal of Health Communication, 2018
The current study examined conversations on Twitter related to use and perceptions of e-cigarettes in the United States. We employed the Social Media Analytic and Research Testbed (SMART) dashboard, which was used to identify and download (via a public API) e-cigaretterelated geocoded tweets. E-cigarette-related tweets were collected continuously using customized geo-targeted Twitter APIs. A total of 193,051 tweets were collected between October 2015 and February 2016. Of these tweets, a random sample of 973 geocoded tweets were selected and manually coded for information regarding source, context, and message characteristics. Our findings reveal that although over half of tweets were positive, a sizeable portion was negative or neutral. We also found that, among those tweets mentioning a stigma of e-cigarettes, most confirmed that a stigma does exist. Conversely, among tweets mentioning the harmfulness of e-cigarettes, most denied that e-cigarettes were a health hazard. These results suggest that current efforts have left the public with ambiguity regarding the potential dangers of e-cigarettes. Consequently, it is critical to communicate the public health stance on this issue to inform the public and provide counterarguments to the positive sentiments presently dominating conversations about e-cigarettes on social media. The lack of awareness and need to voice a public health position on e-cigarettes represents a vital opportunity to continue winning gains for tobacco control and prevention efforts through health communication interventions targeting e-cigarettes. Awareness and use of e-cigarettes have been rapidly increasing among both youth and adults in the United States since nationally representative data collection on e-cigarette use began in 2013 (Center for Disease Control [CDC], 2015). However, carcinogens in e-cigarettes may pose a health threat to e-cigarette smokers, and their use may serve as a gateway drug to traditional cigarette use for non-smokers (Leventhal et al., 2015; Morris et al., 2015; Primack, Soneji, Stoolmiller, Fine, & Sargent, 2015). There are also growing concerns that e-cigarettes may re-normalize smoking behavior, and the general public will no longer see smoking as a negative activity (Fairchild, Bayer, & Colgrove, 2014; Stanwick, 2015). Because of increased use and awareness of e-cigarettes, more research is needed to understand beliefs and sentiments surrounding their use. Attitudes and Beliefs about E-Cigarettes on Twitter Several studies have explored the use of social media to capture the public's sentiments, knowledge, and experience about different health topics (Alvaro et al., 2015; Krauss et al., 2015). These studies included capturing sentiments and experience regarding a range of outcomes such as adverse prescription drug reactions (Alvaro et al., 2015), hookah use (Krauss et al., 2015), and obesity (Kent et al., 2015) using data from Twitter, an online social networking and microblogging site with over 317 million active users across the world (Statista, 2016). Consistent trends across studies show a larger portion of tweets expressing positive sentiments toward e-cigarettes (Godea, Caragea, Bulgarov, & Ramisetty-Mikler, 2015; Myslin, Zhu, Chapman, & Conway, 2013) and a strong presence of advertising and promotional tweets (Huang, Kornfield, Sczcypka, & Emery, 2014). These results are in line with data collected through traditional survey approaches (Harrel et al., 2014) and suggest a vast amount of positive tweets and advertising to which the public is exposed with regard to e-cigarettes. 1 Of the content analyses that have been preformed in this area, it is unclear if they coded for respiratory effects and if data from these studies included robot accounts. While a few studies have analyzed Twitter data to report general sentiments (e.g.,
PloS one, 2017
The reasons for using electronic nicotine delivery systems (ENDS) are poorly understood and are primarily documented by expensive cross-sectional surveys that use preconceived close-ended response options rather than allowing respondents to use their own words. We passively identify the reasons for using ENDS longitudinally from a content analysis of public postings on Twitter. All English language public tweets including several ENDS terms (e.g., "e-cigarette" or "vape") were captured from the Twitter data stream during 2012 and 2015. After excluding spam, advertisements, and retweets, posts indicating a rationale for vaping were retained. The specific reasons for vaping were then inferred based on a supervised content analysis using annotators from Amazon's Mechanical Turk. During 2012 quitting combustibles was the most cited reason for using ENDS with 43% (95%CI 39-48) of all reason-related tweets cited quitting combustibles, e.g., "I couldn't qui...
J Med Internet Res, 2014
Background: In January 2014, the Chicago City Council scheduled a vote on local regulation of electronic cigarettes as tobacco products. One week prior to the vote, the Chicago Department of Public Health (CDPH) released a series of messages about electronic cigarettes (e-cigarettes) through its Twitter account. Shortly after the messages, or tweets, were released, the department's Twitter account became the target of a "Twitter bomb" by Twitter users sending more than 600 tweets in one week against the proposed regulation.