JMIR Publications

ABSTRACT

Background:

Following the signing of the Tobacco 21 Amendment (T21) in Dec 2019 to raise the minimum legal sales age for tobacco products from 18 to 21 years in the US, there is a need to monitor public responses and potential unintended consequences. Social media platforms, such as Twitter, can provide rich data on public perceptions.

Objective:

This study adds to the literature using Twitter data to assess the knowledge and beliefs of T21.

Methods:

Twitter data were collected from Nov 2019 to Feb 2021 using the Twitter streaming application programming interface with keywords related to vaping or e-cigarettes such as “vape”, “ecig” etc. The longitudinal trend of the T21 discussion on Twitter was examined using the mean number of daily T21-related tweets. Inductive methods were used to manually code the tweets into different sentiment groups (positive, neutral, and negative) based on the attitude expressed towards the policy by three authors with high interrater reliability. Topics discussed were examined within each sentiment group through theme analyses.

Results:

Among the collected 3197 tweets, 2169 tweets were related to T21, of which 444 tweets (20.5%) showed a positive attitude, 736 (33.9%) showed a negative attitude, and 989 (45.6%) showed a neutral attitude. The longitudinal trend showed a clear peak around Jan 2020 following the enactment of this legislation. For positive tweets, the most frequent topics were Avoidance of Further Regulation (27.0%), Enforce T21 (24.8%), and Health Benefits (18.2%). For negative tweets, the most frequent topic was General Disagreement/Frustration (28.1%) and Will Still Use Tobacco (25.5%). Neutral tweets were primarily PSA/News posts (79.1%).

Conclusions:

Overall, we observed a more negative attitude toward T21 during our study period. Many were frustrated with T21 and reported that underage consumers would still obtain products. Social media data provides a unique opportunity to monitor public perceptions and responses to regulatory actions. Continued monitoring can inform enforcement efforts and potential unintended consequences of T21.