Vape, quit, tweet? Electronic cigarettes and smoking cessation on Twitter

Jan van der Tempel, Aliya Noormohamed, Robert Schwartz, Cameron Norman, Muhannad Malas, Laurie Zawertailo

Individuals seeking information about electronic cigarettes are increasingly turning to social media networks like Twitter. We surveyed dominant Twitter communications about e-cigarettes and smoking cessation, examining message sources, themes, and attitudes. Tweets from 2014 were searched for mentions of e-cigarettes and smoking cessation. A purposive sample was subjected to mixed-methods analysis. Twitter communication about e-cigarettes increased fivefold since 2012. In a sample of 300 tweets from high-authority users, attitudes about e-cigarettes as smoking cessation aids were favorable across user types (industry, press, public figures, fake accounts, and personal users), except for public health professionals, who lacked consensus and contributed negligibly to the conversation. The most prevalent message themes were marketing, news, and first-person experiences with e-cigarettes as smoking cessation aids. We identified several industry strategies to reach Twitter users. Our findings show that Twitter users are overwhelmingly exposed to messages that favor e-cigarettes as smoking cessation aids, even when disregarding commercial activity. This underlines the need for effective public health engagement with social media to provide reliable information about e-cigarettes and smoking cessation online.