Introduction Tobacco marketing includes text and visual content, which conveys important meaning to consumers and influences use. Little is known about the marketing tactics used by a popular brand of cigarillos on social media to promote their products, including their visual design. Methods A content analysis was conducted to analyze text and visuals for all posts on Swisher Sweets’ official Instagram account from Jan 23 2013 –Feb 28 2020. We assessed product depictions (e.g., warnings, smoking cues), presence of FDA-prohibited or potentially misleading claims (e.g., lower risk, organic), marketing tactics (e.g., celebrities, selling propositions), flavors, and demographic representation. Results We coded 1402 posts. Smoking cues (e.g., images of people smoking, product imagery) were in 764 posts (54.5%), and a warning appeared in 690 (49.2%) posts, but obscured in 29.4% of those instances (n=203). No posts included FDA-prohibited claims, but some potentially misleading language was identified, including the use of words or visual depictions of smooth (n=254, 18.1%) and quality/well-made (n=239, 17%). Marketing tactics such as scarcity (n=159, 11.3%), event promotion (n=586, 41.8%), and alcohol depictions (n=171, 12.2%) were common, and flavor names appeared in 598 posts (42.7%). People depicted were often young adults (n=709, 50.6%), Black/African American (n=549, 39.2%), and in groups (n=473, 33.7%). Conclusions Both text and visuals are used to market Swisher Sweets on their Instagram account. Using social images of young adults, especially Black individuals, signals the intended use of the product. These images of visual-based social media may influence appeal, glamorization, and normalization of cigarillo smoking among vulnerable populations. Implications Tobacco marketing, including from popular cigarillo brands like Swisher Sweets, is widely used to influence consumer perceptions and behavior. Social media marketing includes text and visual, both of which increase product appeal and encourage use. Visual-based social media from the industry itself have been understudied, particularly for cigarillos. This study characterizes the ways in which Swisher Sweets uses text and visuals to market their products through their Instagram account, including smoking cues, potentially misleading language, use of celebrity endorsers, and promotion and sponsorship of events.

BACKGROUND Web-based social support can address social isolation and unmet support needs among young adults with cancer (aged 18-39 years). Given that 94% of young adults own and use smartphones, social media can offer personalized, accessible social support among peers with cancer. OBJECTIVE This study aims to examine the specific benefits, downsides, and topics of social support via social media among young adults with cancer. METHODS We conducted semistructured interviews with young adults with cancer, aged between 18 and 39 years, who were receiving treatment or had completed treatment for cancer. RESULTS Most participants (N=45) used general audience platforms (eg, Facebook groups), and some cancer-specific social media (eg, Caring Bridge), to discuss relevant lived experiences for medical information (managing side effects and treatment uncertainty) and navigating life with cancer (parenting and financial issues). Participants valued socializing with other young adults with cancer, making connections outside their personal networks, and being able to validate their emotional and mental health experiences without time and physical constraints. However, using social media for peer support can be an emotional burden, especially when others post disheartening or harassing content, and can heighten privacy concerns, especially when navigating cancer-related stigma. CONCLUSIONS Social media allows young adults to connect with peers to share and feel validated about their treatment and life concerns. However, barriers exist for receiving support from social media; these could be reduced through content moderation and developing more customizable, potentially cancer-specific social media apps and platforms to enhance one’s ability to find peers and manage groups. CLINICALTRIAL

Parents’ stigmatizing beliefs about the HPV vaccine, such as beliefs that it promotes adolescent sexual activity, constitute a notable barrier to vaccine uptake. The purpose of this study is to describe the associations between parents’ stigmatizing beliefs about the HPV vaccine, psychosocial antecedents to vaccination, and parents’ intentions to vaccinate their children. Parents of vaccine-eligible children ( n = 512) were surveyed in a large urban clinical network. Results indicate that two stigmatizing beliefs were significantly associated with self-efficacy in talking with a doctor about the HPV vaccine. Believing that the vaccine would make a child more likely to have sex was associated with citing social media as a source of information about the vaccine. Other stigmatizing beliefs were either associated with citing healthcare professionals as sources of information about the vaccine, or they were not significantly associated with any information source. This finding suggests that stigmatizing beliefs might discourage parents from seeking out information about the vaccine. This study is significant because it further highlights the importance of doctor recommendations to all patients at recommended ages; doctor visits may represent one of the few opportunities to normalize HPV vaccination and address parents’ stigmatizing beliefs about the HPV vaccine.

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