E-Cigarette Advocates on Twitter: Content Analysis of Vaping-Related Tweets (Preprint)

Abstract

BACKGROUND As the majority of Twitter content is publicly available, the platform has become a rich data source for public health surveillance, providing insight into emergent phenomena, such as vaping. Although there is a growing body of literature that has examined the content of vaping-related tweets, less is known about the people who generate and disseminate these messages, and the role of e-cigarette advocates in the promotion of these devices. OBJECTIVE To identify key conversation trends and patterns over time, and discern the core voices, message frames and sentiment surrounding e-cigarette discussions on Twitter through a content analysis of tweets posted and retweeted by Australian users. METHODS Data were collected through TrISMA (Tracking Infrastructure for Social Media Analysis), a contemporary technical and organizational infrastructure for the tracking of public communication by Australian users of social media, via a list of 15 popular e-cigarette related terms. RESULTS A sample of 4432 vaping related tweets from 2012, 2014, 2016 and 2018, posted and retweeted by Australian users was analyzed. The analysis of the tweet content indicates that positive sentiment (3754, 84.7%) continues to dominate the discourse surrounding e-cigarettes on Twitter. Vape retailers and manufacturers (26.2%, 1161/ 4432), the general public (everyday persons) (24.3%, 1079/4432), and vape proponents (23.4%, 1038/4432) were the most prominent posters of e-cigarette related tweets. These account types most frequently posted and retweeted advertising and promotional content, support for e-cigarettes as a smoking cessation product or tobacco alternative, support for liberal e-cigarette regulation, and endorsement of the perceived health and safety benefits of these products. Furthermore, a number of tactics were used by vape proponents to communicate their beliefs, including attempts to frame e-cigarettes as safer than traditional smoking, denounce as propaganda gateway claims that youth who use e-cigarettes can progress to using combustible tobacco, and imply that federal government agencies lack sufficient competence or the evidence for the policies they endorse around vaping. CONCLUSIONS Australian Twitter content does not reflect the country’s current regulatory approach to e-cigarettes. Rather, the conversation on Twitter generally encourages e-cigarette use, promotes vaping as a socially acceptable practice, discredits scientific evidence of health risks, and rallies around the idea that e-cigarettes should largely be outside the bounds of health policy. The one-sided nature of the discussion is concerning, as is the lack of disclosure and transparency, especially among vaping enthusiasts who dominate the majority of e-cigarette discussion on Twitter where it is unclear if comments are endorsed, sanctioned or even supported by industry. Further insight into Twitter user’s profiles and their connections is required to fully understand how misinformation and disinformation spreads online, to develop data driven solutions to this growing threat, and to enhance the role of public health institutions in sharing quality information.