Content Analysis of Nicotine Poisoning (Nic Sick) Videos on TikTok: Retrospective Observational Infodemiology Study

Abstract

Background TikTok is a microvideo social media platform currently experiencing rapid growth and with 60% of its monthly users between the ages of 16 and 24 years. Increased exposure to e-cigarette content on social media may influence patterns of use, including the risk of overconsumption and possible nicotine poisoning, when users engage in trending challenges online. However, there is limited research assessing the characteristics of nicotine poisoning–related content posted on social media. Objective We aimed to assess the characteristics of content on TikTok that is associated with a popular nicotine poisoning–related hashtag. Methods We collected TikTok posts associated with the hashtag #nicsick, using a Python programming package (Selenium) and used an inductive coding approach to analyze video content and characteristics of interest. Videos were manually annotated to generate a codebook of the nicotine sickness–related themes. Statistical analysis was used to compare user engagement characteristics and video length in content with and without active nicotine sickness TikTok topics. Results A total of 132 TikTok videos associated with the hashtag #nicsick were manually coded, with 52.3% (69/132) identified as discussing firsthand and secondhand reports of suspected nicotine poisoning symptoms and experiences. More than one-third of nicotine poisoning–related content (26/69, 37.68%) portrayed active vaping by users, which included content with vaping behavior such as vaping tricks and overconsumption, and 43% (30/69) of recorded users self-reported experiencing nicotine sickness, poisoning, or adverse events such as vomiting following nicotine consumption. The average follower count of users posting content related to nicotine sickness was significantly higher than that for users posting content unrelated to nicotine sickness (W=2350.5, P=.03). Conclusions TikTok users openly discuss experiences, both firsthand and secondhand, with nicotine adverse events via the #nicsick hashtag including reports of overconsumption resulting in sickness. These study results suggest that there is a need to assess the utility of digital surveillance on emerging social media platforms for vaping adverse events, particularly on sites popular among youth and young adults. As vaping product use-patterns continue to evolve, digital adverse event detection likely represents an important tool to supplement traditional methods of public health surveillance (such as poison control center prevalence numbers).

Leveraging Rights of Data Subjects for Social Media Analysis: Studying TikTok via Data Donations

“…Compared to YouTube, this daily consumption is larger (based on one report, users spent 19 average daily minutes on YouTube in 2022 [24]), despite the fact that YouTube's videos have a longer duration. Also, we find that younger participants (aged between 18-24 years old) spent more time on Tik-Tok compared to older participants (e.g., aged between [25][26][27][28][29][30][31][32][33][34]. This result prompts the need for further investigation into how younger people use TikTok, particularly, to investigate potential social media addiction.…”

“…Much of the prior work on TikTok has studied the recommendation algorithm [40,1,6,18,35,34], the content on the platform [3,13,28,46,19,48,37,21,44,45,31], and performed user studies on TikTok users [49,32,17,18,26,8,30,22]. To the best of our knowledge, our work is the first to investigate user behavior through the lens of data donated directly from users using the rights of data subjects.…”

Synthetic Cannabinoids in Prisons: Content Analysis of TikToks

“…Manual annotation and content analysis of the TikTok videos were conducted by TJM, AC, and MCN. Coding was approached inductively due to the exploratory nature of the study, prior studies that have examined TikTok primarily using an inductive coding approach for TikTok videos and texts, and due to the lack of existing studies that have coded TikTok content related to synthetic drugs [ 14 ]. Authors generated a data set with binary classifications of whether the video discussed content related to adverse effects, selling, and consumption of K2/Spice.…”

“…Although it has also been increasingly used to obtain health-related information, especially during the COVID-19 pandemic, the quality of information on TikTok can vary widely, may not always be reliable, and can be harmful [10][11][12]. Harmful information found on TikTok includes sharing experiences and positive sentiment related to substance use [13][14][15].…”

What drives me to use TikTok: A latent profile analysis of users’ motives

“…Given the prominence of TikTok, studies from different cultures have focused on its use in various contexts, such as entertainment ( Meng and Leung, 2021 ), political communication ( Cervi et al, 2021 ), and infodemiology ( Purushothaman et al, 2022 ). The motivations underlying its use have drawn researchers’ attention (for review, see Montag et al, 2021 ).…”