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

Abstract

BackgroundThe use of e-cigarettes is proliferating globally, especially among youth and even children. Marketing is a known risk factor for e-cigarette initiation, yet little is known of e-cigarette marketing on social media in low- and middle-income countries. This study compares e-cigarette social media marketing in India, Indonesia, and Mexico, three such countries with different regulatory environments.MethodsInstances of e-cigarette marketing on social media platforms were identified via the Tobacco Enforcement and Reporting Movement (TERM), a digital tobacco marketing monitoring system. Through systematic keyword-based searches, all tobacco marketing posts observed between 15 December 2021 and 16 March 2022 were included in the analysis. The final sample included 1,437 e-cigarette-related posts on Instagram, Facebook, Twitter, YouTube, and TikTok, which were systematically content analyzed by independent coders after inter-reliability (Cohen's Kappa K > 0.79) was established using a theory-derived codebook. The final data is represented in percentages and frequencies for ease of presentation.ResultsWe observed e-cigarette marketing online in all countries studied, yet there was variation in the volume of marketing and types of accounts identified. In India, where e-cigarettes were comprehensively banned, we identified 90 (6%) posts; in Mexico, where e-cigarettes were partially restricted, 318 (22%) posts were observed; and in Indonesia, where there were no restrictions, 1,029 (72%) posts were observed. In both India and Mexico, marketing originated from retailer accounts (100%), whereas in Indonesia, it was primarily product brand accounts (86%). Across countries, e-cigarettes were mostly marketed directly to sell products (India: 99%, Indonesia: 69% and Mexico: 93%), though the sales channels varied. Product features, including e-liquid flavors, device colors and technical specifications, was the most prominent message framing (India: 86%; Mexico: 73%; Indonesia: 58%). Harm reduction messaging was most popular in Mexico (8%) and was not common in Indonesia (0.3%) or India (0%).ConclusionOur study provides important insights for tobacco control stakeholders on the evolving nature of e-cigarette marketing in low- and middle-income countries. It underscores the presence of e-cigarette marketing, including in countries where comprehensive regulations exist, and suggests the importance of continuous monitoring to keep up with industry practices and strengthen tobacco control stakeholder efforts to counter them.

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

“…Online marketing and sales of e-cigarette are well-established strategies of tobacco companies [11,25,26]. Hence several researchers have studied online marketing, and content analyses of social media websites [25,27].…”

“…Claims about lifestyle bene ts of e-cigarette such as making claims of improved social status, modernity are reported in previous studies [11,[14][15][16]]. In addition, the claims about affordability, convenience, are aimed to encourage uptake of e-cigarette by the non-smoking youth and young adults by making ecigarette appear as healthier, less risky, and socially appealing.…”

“…There are a few reports on product types in China, Indonesia, and Nigeria [16, 23,24] and selling propositions in South Africa [15]. Another study has reported about social media marketing in India, Indonesia and Mexico [11]. Therefore, the need to study the content of e-cigarette manufacturer websites to better inform policymakers about regulations for internet-based e-cigarette retailers.…”

Does India's Ban on Electronic Cigarettes Improve Public Health Outcomes?

“…Advertisements for e-cigarettes in India continue to be broadcast on social media through third-party retailers. The Indian market actually provides customers with covert options for buying e-cigarettes through phone numbers and WhatsApp (Murukutla et al 2022).…”

“…In India, 86% of e-cigarette advertisements on social media focused on attractive product features such as novel device designs, flavours, touch screen indicators, and product customizability (Murukutla et al 2022). The study found that compared to Mexico and Indonesia, India had the highest engagement with social media posts that emphasised such product features.…”