Background Electronic nicotine delivery systems (ENDS) are the most-used tobacco product by adolescents, and Juul has rapidly become the most popular ENDS brand. Evidence indicates that Juul has been marketed heavily on social media. In light of recent lawsuits against the FDA spurred by claims that the agency responded inadequately to this marketing push, measuring the social media conversation about ENDS like Juul has important public health implications.
Methods We employed search filters to collect Juul-related and other ENDS-related data from Twitter in 2017–2018 using Gnip Historic PowerTrack. Trained coders labelled random samples for Juul and ENDS relevance, and the labelled samples were used to train a supervised learning classifier to filter out irrelevant tweets. Tweets were geolocated into US counties and their fitness for use was assessed.
Results The amount of Juul-related tweets increased 67 times over the study period (from 18 849 in the first quarter of 2017 to 1 287 028 in the last quarter of 2018), spreading widely across US counties. By the last quarter 2018, 34% of US counties had more than 6 Juul-related posts per 10 000 people, up from 0% in the first quarter 2017. However, during the same period, the total of non-Juul ENDS-related tweets decreased by 25%.
Conclusions Juul-related content grew exponentially on Twitter and spread across the entire country during the time when the brand was gaining market share. This social media buzz continued to increase even after FDA’s multiple interventions to curb promotions targeting minors.
- electronic nicotine delivery devices
- surveillance and monitoring
- social marketing
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Twitter @kimysangy, @sherryemery, @JidongHuang
Contributors All authors together designed the study; YK collected data and conducted data analysis; YK, SLE and JH contributed to data interpretation; BD conducted data analysis; LV wrote the first draft; all authors revised the draft; the final version of the paper has been reviewed and approved by all coauthors.
Funding This research is supported by a grant funded by the National Institutes of Health (NIH) and National Cancer Institute (NCI) (R01CA194681-04S1) (Principal investigator: JH).
Disclaimer The National Cancer Institute did not play any role in study design; in the collection, analysis and interpretation of data; in the writing of the paper; or in the decision to submit the article for publication. The opinions expressed here are those of the authors and do not necessarily reflect those of the sponsors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was reviewed and determined not to be human subjects research by the Institutional Review Board at NORC at the University of Chicago (IRB00000967), under its Federal Assurance #FWA00000142.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on request. Please contact YK (firstname.lastname@example.org) to request access to the data.
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