Introduction With over 1 billion monthly users globally, a third of whom are under 14 years, TikTok's popularity is indisputable. Publicly available cannabis‐related content on this platform may influence perceptions of cannabis use. We aimed to examine how cannabis‐related videos are portrayed on TikTok. Methods Data were collected from TikTok using hashtag‐based keywords on cannabis‐related videos (n = 1377). Seven researchers documented video metrics (i.e. views, likes, comments) and independently coded videos for sentiment and theme. Results After removing duplicates and non‐related content, the final sample contained 881 videos. These videos had a median view count of 518 700 (SD = ±1 082 905), median likes count of 99 900 (SD = ±206 647) and median comment count of 931 (SD = ±2977). Many videos portrayed cannabis use positively (54.14%; collectively viewed 417 million times), with 15.84% of this subset actively depicting cannabis or administration products. The thematic analysis identified seven non‐mutually exclusive themes. Content portraying cannabis use as entertaining or humorous accounted for 71.74% of videos, with a further 42.90% discussing personal cannabis use experiences and 24.63% promoting the social and cultural acceptability of cannabis use. Discussion and Conclusions Our sample revealed over half of videos portrayed cannabis use positively and none were age restricted. All were publicly accessible through standard web and smartphone applications. With previous research demonstrating that exposure to cannabis‐related content can influence adolescents' attitudes and problematic cannabis use, it is important more effective age restrictions and regulations are introduced to social media platforms.

Aims: There is a growing body of literature exploring the types of substance-related content and their portrayals on various social media platforms. We aimed to summarize how content related to substances is portrayed on various social media platforms.Methods: This systematic review was pre-registered on PROSPERO (ref: CRD42021291853). A comprehensive search was conducted in the databases of PubMed, Scopus, PsycINFO and Web of Science in April 2021. Original qualitative studies published post-2004 that included thematic and sentiment analyses of social media content on tobacco, alcohol, psychostimulant, e-cigarette, cannabis, opiate, stimulant/ amphetamine, inhalant and novel psychoactive substance were included. Social media platforms were defined as online web-or application-based platforms that allowed users to generate content and interact via 'liking', comment or messaging features. Only studies that included summative and/or thematic content analyses of substance-related social media content were included.Results: A total of 73 studies, which covered 15 905 182 substance-related posts on Twitter, YouTube, Instagram, Pinterest, TikTok and Weibo, were identified. A total of 76.3% of all substance-related content was positive in its depiction of substance use, with 20.2% of content depicting use negatively. Sentiment regarding opiate use however was commonly negative (55.5%). Most studies identified themes relating to Health, Safety and Harms (65.0%) of substance use. Themes relating to Promotions/ Advertisements (63.3%), Informative content (55.0%) and Use behaviours (43.3%) were also frequently identified.Conclusions: Substance-related content that promotes engagement with substance use or actively depicts use appears to be widely available on social media. The large public presence of this content may have concerning influences on attitudes, behaviours and risk perceptions relating to substance use, particularly among the most vulnerable and heaviest users of social media-adolescents and young adults.

Aim: There are concerns regarding what young people are exposed to on TikTok due to trending content promoting e-cigarette use through humour, marketing and lifestyle acceptability. Using baseline data from November 2020, we aimed to examine how much content from a sample of popular vaping videos remained accessible at 9- and 12-month follow-ups. We aimed to monitor changes in viewer engagement (using metadata) before and after the U.S. Congressional Hearing on youth protection measures on social media in October 2021. Methods: Hashtag-based keywords were used to collect the most viewed publicly available e-cigarette related videos on TikTok (N = 802) from inception to November 2020 to form a baseline. Researchers conducted a longitudinal descriptive study using this data, with 9- and 12-month follow-ups to measure changes in viewer engagement (using metadata) and content availability. Findings: Of the 802 videos from the baseline, 562 remained at the 9-month follow-up and 511 remained at the 12-month follow-up. At the 12-month follow-up, the majority of vaping-related hashtags were removed by TikTok after the Congressional Hearing. Between the baseline and 9-month follow up, views increased by 1.4% and likes increased by 4.4%. At 12-month follow-up, views had increased by 1.7% and likes by 4.2% compared to baseline data. Whilst 291 videos were no longer publicly accessible at 12-month follow-up, 39 of these were made inaccessible by the content creators. The most viewed and most liked vaping videos at baseline were still publicly available. Conclusions: Whilst the depiction type and thematic distribution of removed videos suggest that TikTok may be removing a small proportion of content that promotes the use of e-cigarettes, metadata of remaining videos indicate an increase in viewer engagement. TikTok’s removal of explicit substance-related hashtags from the platform could be a step towards preventing adolescents from being exposed to harmful behaviours and substances online. However, the platform should consider enforcing effective age restrictions on content that promotes substance use in a positive light.

Background and Aims: Heated tobacco products (HTPs) are electronic devices that heat process tobacco to release an aerosol containing nicotine and other chemicals. Limited data exist on world-wide HTP use prevalence. This meta-analytic review estimated the prevalence of HTP use by country, World Health Organization (WHO) region, year, sex/gender and age. Methods: Five databases (Web of Science, Scopus, Embase, PubMed and PsycINFO) were searched between January 2015 and May 2022. Included studies reported the prevalence of HTP use in nationally representative samples post-modern HTP device market entry (2015). A random-effects meta-analysis was used to estimate overall prevalence for life-time, current and daily HTP use. Results: Forty-five studies (n = 1 096 076) from 42 countries/areas from the European Region (EUR), Western Pacific Region (WPR), Region of the Americas (AMR) and African Region (AFR) met inclusion criteria. Estimated pooled prevalence for life-time, current and daily HTP use was 4.87% [95% confidence interval (CI) = 4.16, 5.

Aim To test (1) if there was a change in self‐reported lifetime prevalence of meth/amphetamine use by birth cohort and (2) if the extent of under‐reporting of meth/amphetamine use was associated with the proportion of the population who nominated meth/amphetamine as a drug problem. Design Observational study using seven waves of repeated cross‐sectional nationally representative household surveys between 2001 and 2019. Setting Australia. Participants Participants were from three birth cohorts: 1951–60 (age 68–77 at the 2019 survey; n = 29 458; 55% female), 1961–1970 (age 58–67; n = 29 859; 57% female) and 1971–1980 (age 48–57; n = 28 758; 59% female). Data were weighted to align the sample to the Australian population. Measurements Past year meth/amphetamine use; under‐reporting of lifetime meth/amphetamine use in each birth cohort, year and survey stratum (operationalised as the difference between self‐reported lifetime prevalence in 2001 and that of each subsequent year); proportion of the population who nominated meth/amphetamine as a drug problem in each birth cohort, year and survey stratum. Under‐reporting was regressed on the proportion of people holding negative attitude towards meth/amphetamine. Survey year and birth cohort were adjusted for. Findings Between 2001 and 2019, the lifetime prevalence of meth/amphetamine decreased from 6.1% (95% CI = 5.3–6.9) to 1.7% (95% CI = 1.2–2.2) in the 1951–1960 birth cohort (p < 0.001), from 13.0% (95% CI = 12.0–14.1) to 4.4% (95% CI = 3.7–5.2) in the 1961–1970 birth cohort (p < 0.001) and from 21.4% (95% CI = 19.9–22.9) to 11.2% (95% CI = 10.0–12.4) in the 1971–1980 birth cohort (p < 0.001). The proportion who nominated meth/amphetamine as a ‘drug problem’ increased significantly in all three cohorts (all p < 0.001) and the degree of under‐reporting of meth/amphetamine use was significantly associated with proportion of people who nominated meth/amphetamine as the ‘drug problem’ (b = 0.09, SE = 0.01, p < 0.001). Conclusion In Australia, the actual prevalence of lifetime meth/amphetamine use may be two‐ to fourfold higher than that estimated in the most recent national household surveys (2019). The level of under‐reporting is strongly associated with increasing negative attitudes towards methylamphetamine and d‐amphetamine use over the same period.