JMIR Publications

ABSTRACT

Background:

Understanding how social media platforms facilitate information exchange and influence behavior during health crises can enhance public health response during times of uncertainty.

Objective:

This study aimed to characterize and contextualize e-cigarette-related behavior changes during the early COVID-19 pandemic and illuminate the role that social media played in decision making.

Methods:

We conducted a qualitative analysis of COVID-19-related e-cigarette discussions on three Reddit forums about e-cigarettes. Posts were collected from June 27 to July 3, 2020 (discussion threads=189; comments=3,155). We developed and applied emergent codes, identified thematic patterns across codes, and developed a model to synthesize the social-ecological context of e-cigarette behaviors.

Results:

E-cigarette subreddits provided a platform for Redditors with similar experiences, ideas, and perspectives on the world to have rich conversations about perceptions and experiences with e-cigarettes. Discussions reflected an array of e-cigarette-related behaviors, including increases and decreases in use intensity and changes in purchasing practices. Redditors drew from their existing perceptions, intentions, and experiences with e-cigarettes; their personal pandemic experience; and their participation on Reddit to decide about whether and how to change their e-cigarette behaviors during the early pandemic. Consumption and discussion of media (e.g., news articles, peer-reviewed publications) on Reddit informed e-cigarette behaviors. Decisions were complicated by distrust of the media.

Conclusions:

Changes in work and activity space, and information, misinformation, and discussion from Reddit informed risk perceptions and decisions during the pandemic. Moving forward, messaging should consider the stress, struggles, and stigma of people who use e-cigarettes and address the roles mistrust and misinformation play in decisions.