JMIR Publications

ABSTRACT

Background:

Electronic cigarettes have become increasingly popular. China has accelerated its legislation on e-cigarettes in recent years by issuing two policies to regulate their use; firstly, on August 26, 2018 and secondly, on November 1, 2019. Social media provides an efficient platform to access information on the public opinion of e-cigarettes.

Objective:

In order to get an insight into how policies have influenced the reaction of the Chinese public to e-cigarettes, this study seeks to understand what the Chinese public say about e-cigarettes, and how the focus of discussion might have changed in the context of policy implementation.

Methods:

This study used a combination of text mining and correspondence analysis. From January 1, 2017 to December 31, 2019, Python was used to text mine the most frequently used words/phrases in public e-cigarette discussion on Zhihu, China’s largest question-and-answer platform and one of the country’s most trustworthy social media sources. Correspondence analysis was used to examine the similarities and differences between high-frequency words across three time periods (i.e., 2017/1/1-2018/8/27, 2018/8/28-2019/10/31, 2019/11/1-2020/1/1).

Results:

Results showed that the consistent themes across time were comparisons with traditional cigarettes; health concerns; and how to choose e-cigarette products. The issuance of government policies on e-cigarettes led to a change in the focus of public discussion. The discussion of e-cigarettes in period 1 mainly focused on the use and experience of e-cigarettes. In period 2, the public’s attention was not only on the substances related to e-cigarettes, but also on the smoking cessation functions of e-cigarettes. In period 3, the public shifted their attention to the e-cigarette industry and government policy on the banning of sales of e-cigarettes to minors.

Conclusions:

Social media is an informative source which can help policymakers and public health professionals understand the public's concerns over and understanding of e-cigarettes. When there was little regulation, public discussion was greatly influenced by industry claims about e-cigarettes; however, once e-cigarette policies were issued, these policies, to a large extent, set the agenda for public discussion. In addition, media reporting of these policies might have greatly influenced the way e-cigarette policies were discussed. Therefore, monitoring e-cigarette discussion on social media and responding to it in a timely manner will both help improve the public's e-cigarette literacy and facilitate the implementation of e-cigarette related policies. Clinical Trial: Not Applicable.