JMIR Publications

ABSTRACT

Background:

Examining public perception of tobacco products is critical for effective tobacco policy making and public education outreach. While the link between traditional tobacco products and lung cancer is well established, it is not known how the public perceives the association between e-cigarettes and lung cancer. In addition, it is unclear how the public interact with official messages during cancer campaigns on tobacco consumption and lung cancer.

Objective:

This study aims to analyse e-cigarettes and smoking tweets in the context of lung cancer during the 2018 National Cancer Prevention Month, and examine how e-cigarettes and traditional tobacco products discussions relate to implementation of tobacco control policies across different states in the U.S.

Methods:

We mined a dataset of English-based lung cancer tweets that contained the term “lung cancer” on Twitter. The dataset had 13,946 publicly available tweets obtained during the National Cancer Prevention Month (i.e., February) and 10,153 tweets obtained during March in 2018 in the US. E-cigarette- and smoking-related tweets were retrieved and analysed using topic modelling and geospatial approaches.

Results:

Results from topic modelling showed that “e-cigarette debates” on its harmfulness (49.7%), “personal experiences” (34.5%), and “e-cigarette risks” (15.8%) were the three major themes of e-cigarette tweets related to lung cancer. Meanwhile, “policy discussions” (58.1%), “smoking risks” (21.8%), and “personal experiences” (20.1%) were the three major themes of smoking tweets related to lung cancer. Geospatial analysis revealed that discussion on e-cigarettes risks was positively correlated with the number of state-level smoke-free policies enacted for e-cigarettes. Particularly, the number of smoke-free policies both indoor and in campus was related to the tweet number of the “e-cigarette risks” theme (smoke-free indoor, r(49) = .33, P = .018; smoke-free campus, r(49) = .32, P = .022). The total number of e-cigarette policies was also related to the tweet number of “e-cigarette risks”, r(49) = .32, P = .024. In contrast, the number of smoking policies did not yield significant correlations with the number of tweets of any smoking themes in the lung cancer discourse.

Conclusions:

While people recognised the importance of smoking control policies and reduction of lung cancer, their views on e-cigarettes risks were divided, and discussions on the importance of e-cigarettes policy control were missing. Findings suggests the need for public health organizations to continuously engage the public in discussions on the potential health risks as well as raise awareness of the insidious lobbying efforts from the tobacco industry.