• electronic nicotine delivery devices
• media
• advertising and promotion

Since 2 January 2020, the US Food and Drug Administration banned sales of all flavoured (other than menthol or tobacco) pod-mod e-cigarettes, like JUUL, that appeal to youth.1 However, the finalised policy exempted disposable e-cigarettes such as Puff Bar, Posh, Eon Stik, Mr. Vapor and other brands that are illegally introduced into the market and gaining popularity among youth.2

The objective of this Industry Watch article is to describe how Puff Bar e-cigarettes, a leading disposable e-cigarette brand among youth,3 are portrayed on the popular Beijing-based video-sharing social media platform TikTok.4 Unlike other major e-cigarette companies, information on the ownership of the Puff Bar company is unclear.5 We focused on TikTok specifically because 60% of the platform’s 26.5 million active users in the USA in 2019 were between the ages of 16 and 24.6 TikTok’s user guidelines prohibit the posting of ‘content that depicts minors consuming, possessing, or suspected of consuming alcoholic beverages, drugs, or tobacco’.7 However, on other social media such as Facebook, enforcement of such policies to restrict promotion of tobacco products is lacking.8 Information on the presence of content related to disposable vaping products on TikTok is important because the spread of posts related to the use of Puff Bars may normalise the use of disposable e-cigarettes among youth.

Between March and May 2020, we searched for English language TikTok videos that explicitly portrayed Puff Bars using search terms and hashtags related to Puff Bars (eg, Puff Bar, #PuffBar and #nicotine). We identified the top 10 videos based on the number of views. Online supplemental appendix 1 summarises characteristics of each video after removing identifying information. Next, we summarised information from the 10 TikTok user accounts including number of followers, number of views, likes, caption and date of the video post. Both authors reviewed each video and coded the videos using a coding scheme adapted from Czaplicki and colleagues9 into four major categories: (1) sale or promotional content, (2) nicotine and addiction-related content, (3) youth-related content, and (4) flavours. Both coders discussed any discrepancies and reached consensus on all codes. We summarised the coding results in online supplemental appendix 1 in order of the popularity of these videos.

The top 10 TikTok videos portraying Puff Bars were viewed between 2.8 and 42.4 million times and received between 285 000 and 4 million ‘likes’. Videos were posted between November 2019 and May 2020. TikTok users who posted these videos had between 7357 and over 587 000 followers. Two videos contained sale or promotional content by featuring convenience store owners who sold Puff Bars to a young customer. Nine videos featured nicotine or addiction-related content. For instance, the three most popular videos portrayed variations of pushing a large number of used Puff Bars off the edge of a desk with a background audio recording stating ‘nicotine addiction check’ and suggested the addictiveness of vaping Puff Bars. Another example of addiction-related content was a video showing an individual frantically unwrapping a Puff Bar package to vape because he ‘hasn’t had nicotine all day’ and included the hashtag #nicotineaddiction. Two videos featured youth-related content. In one video, a convenience store owner verified the age of an underage customer (depicted as age 14) and allowed him to purchase a Puff Bar at a convenience store with a ‘+4’ card from the game Uno. The second video featured a user saying ‘Dad I think I have a problem’ in relation to nicotine addiction. Eight videos explicitly featured different Puff Bar flavours (eg, Lush Ice, Watermelon, Mango). One video was not categorised into any of these codes and portrayed how a user repaired a broken Puff Bar.

Ten of the most viral videos portraying Puff Bars garnered millions of views among TikTok users. Nicotine or addiction-related content and flavours were present in the majority of these 10 videos. Two of the top 10 videos included sale or promotional content and two explicitly portrayed underage youth. Our analysis was limited to one brand of disposable e-cigarettes on TikTok. We were not able to determine if TikTok videos featuring Puff Bars were sponsored by the company or retailers as users did not disclose any such sponsorship. However, the use of social media influencers on Instagram by JUUL has been previously described.10 Further research is needed to monitor social media content portraying Puff Bars and other popular brands of disposable e-cigarettes across different social media platforms frequently used by youth and to examine the impact of exposure to this content on youth initiation of vaping products. Efforts are needed to regulate and ensure oversight on TikTok’s practices and to denormalise the presence of vaping behaviour on social media platforms.