Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 11, 2021
Date Accepted: Feb 3, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Social Media Monitoring of Emerging Public Health Concerns: Puff Bars, Tobacco Policy Evasion, and Nicotine Dependence
ABSTRACT
Background:
Laws and regulations around e-cigarettes are rapidly changing in response to increased concern about the use of the products by youth, and prior research suggests the focus of flavor bans on devices such as JUUL may have created a policy loophole that was filled by disposable devices such as Puff Bar.
Objective:
To examine discussions related to Puff Bar, a disposable e-cigarette device, on Twitter to identify tobacco regulation and policy themes as well as unanticipated outcomes of regulatory loopholes.
Methods:
Of 8519 original tweets related to Puff Bar collected from 7/13/2020 to 8/13/2020, a 20% subsample (n=2661) were selected for qualitative coding of topics related to nicotine dependence and tobacco policy.
Results:
Of the human-coded tweets, 2123 (80.2%) were coded as relevant. Of relevant tweets, 698 (32.9%) discussed topics relevant to tobacco policy, including flavors (45.9%, n=320), regulations (17.8%, n=124), purchases (16.8%, n=117), and other products (15.8%, n=110). Approximately 22% (n=480) of tweets referenced dependence, including lack of access (56.9%, n=273), appetite suppression (12.3%, n=59), frequent use (9.8%, n=47) and self-reported dependence (22.9%, n=110).
Conclusions:
The United States FDA ban of e-cigarette flavors did not reduce demand, but rather shifted the supply to brands utilizing a loophole for disposable devices. Until comprehensive tobacco policy legislation is developed, new products or loopholes will continue to supply nicotine demand.
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