JMIR Publications

ABSTRACT

Background:

In response to the recent government bans, flavored JUUL products, which are rechargeable closed-system pod mods, are no longer available for sale. However, disposable closed-system products such as the flavored Puff Bar continues to be available. If electronic cigarette (e-cigarette) consumers simply switch between products in the face of government bans limited to one type of product over another, then such bans would be less effective. A step forward in this line of research is to understand how the public discusses these products by examining discourse referencing both Puff Bar and JUUL in the same conversation. Twitter data provides ample opportunity to capture such early trends that could be used to help public health researchers stay abreast of the rapidly changing e-cigarette marketplace.

Objective:

The goal of this study was to examine public discourse referencing both Puff Bar and JUUL in the same conversation on Twitter.

Methods:

Data was collected from Twitter’s Streaming API between July 16, 2019 to August 29, 2020, that contained both “puff bar” and “juul” (n = 2,632). The research team then used an inductive approach to become familiar with the data and generate a codebook to identify common themes. Saturation was determined to be reached with 10 themes.

Results:

Posts often mentioned flavors, dual use, design features, youth use, health risks, switching one product for the other, price, confusion over the differences between products, longevity of products, and nicotine concentration levels.

Conclusions:

A comprehensive tobacco control program may include identifying new products that circumvent regulations through surveillance of social media and of the online marketplace. Policies aimed at curbing youth-appealing device features and standardizing labeling of nicotine concentration levels may be necessary to prevent youth uptake and consumer confusion. Future health communication campaigns may also consider targeting the health consequences of using multiple e-cigarette products or dual use to reduce exposure to high levels of nicotine among younger populations.