Accepted for/Published in: JMIR Infodemiology
Date Submitted: Aug 16, 2022
Date Accepted: Feb 6, 2023
Health Warning Labels and Engagement in Little Cigar and Cigarillo Instagram Promotions: Using Computer Vision to Detect Compliance with FDA Guidelines
ABSTRACT
Background:
Health warnings in tobacco advertising provide health information while also increasing the perceived risks of tobacco use. However, existing federal laws requiring warnings on advertisements for tobacco products do not specify whether the rules apply to social media promotions.
Objective:
This study aims to examine the current state of influencer promotions of little cigars and cigarillos (LCCs) on Instagram and the use of health warnings in influencer promotions.
Methods:
Instagram influencers were identified as those who were tagged by any of the three leading LCC brand Instagram pages between 2018 and 2021. Posts from identified influencers that mentioned one of the three brands were considered LCC influencer promotions. A novel Warning Label Multi-Layer Image Identification (WaLi) computer vision algorithm was developed to measure the presence and properties of health warnings in a sample of 889 influencer posts. Negative binomial regressions were performed to examine the associations of health warning properties with post engagement.
Results:
The WaLi algorithm was 99.3% accurate in detecting the presence of health warnings. Only 8.2% (n = 73) of LCC influencer posts included a health warning. Negative binomial results showed posts that contained health warnings received fewer likes (IRR = 0.59, CI = 0.49, 0.71) and comments (IRR = 0.47, CI = 0.32, 0.68).
Conclusions:
Health warnings are rarely used by influencers tagged by LCC brand Instagram accounts. Very few influencer posts met the FDA health warning requirement of size and placement for tobacco advertising. The presence of a health warning was associated with lower online engagement. Our study provides support for the implementation of comparable health warning requirements to social media tobacco promotions. Using an innovative computer vision approach to detect health warning labels in influencer promotions on social media is a novel strategy for monitoring health warning compliance in online tobacco promotions.
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