Smokers’ Likelihood to Engage With Information and Misinformation on Twitter About the Relative Harms of e-Cigarette Use: Results From a Randomized Controlled Trial

Abstract

Background Information and misinformation on the internet about e-cigarette harms may increase smokers’ misperceptions of e-cigarettes. There is limited research on smokers’ engagement with information and misinformation about e-cigarettes on social media. Objective This study assessed smokers’ likelihood to engage with—defined as replying, retweeting, liking, and sharing—tweets that contain information and misinformation and uncertainty about the harms of e-cigarettes. Methods We conducted a web-based randomized controlled trial among 2400 UK and US adult smokers who did not vape in the past 30 days. Participants were randomly assigned to view four tweets in one of four conditions: (1) e-cigarettes are as harmful or more harmful than smoking, (2) e-cigarettes are completely harmless, (3) uncertainty about e-cigarette harms, or (4) control (physical activity). The outcome measure was participants’ likelihood of engaging with tweets, which comprised the sum of whether they would reply, retweet, like, and share each tweet. We fitted Poisson regression models to predict the likelihood of engagement with tweets among 974 Twitter users and 1287 non-Twitter social media users, adjusting for covariates and stratified by UK and US participants. Results Among Twitter users, participants were more likely to engage with tweets in condition 1 (e-cigarettes are as harmful or more harmful than smoking) than in condition 2 (e-cigarettes are completely harmless). Among other social media users, participants were more likely to likely to engage with tweets in condition 1 than in conditions 2 and 3 (e-cigarettes are completely harmless and uncertainty about e-cigarette harms). Conclusions Tweets stating information and misinformation that e-cigarettes were as harmful or more harmful than smoking regular cigarettes may receive higher engagement than tweets indicating e-cigarettes were completely harmless. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 16082420; https://doi.org/10.1186/ISRCTN16082420

Effects of brief exposure to misinformation about e-cigarette harms on Twitter on knowledge and perceptions of e-cigarettes

“… 14 Participants were also more likely to engage with (e.g. share, like) tweets that e-cigarettes were just as or more harmful than smoking, 15 we also found that affective responses and perceived relative harm following exposure to misinformation about e-cigarette harms may mediate the relationship with intention to purchase e-cigarettes. 16 …”

“…14 Participants were also more likely to engage with (e.g. share, like) tweets that e-cigarettes were just as or more harmful than smoking, 15 we also found that affective responses and perceived relative harm following exposure to misinformation about e-cigarette harms may mediate the relationship with intention to purchase e-cigarettes. 16 This current study examined the effect of brief exposure to misinformation found on Twitter about e-cigarette harms on smoker's knowledge and harm perceptions of e-cigarettes relative to combustible cigarettes, across US versus UK populations.…”

“…like, share), and emotions produced by the message (results presented elsewhere). 15 , 16 After exposure, participants completed post-test measures of knowledge and harm perceptions. They then answered questions on smoking behavior, prior e-cigarette misinformation exposure, social media use and demographic characteristics.…”

Characteristics Associated with Young Adults’ Intentions to Engage with Anti-Vaping Instagram Posts

“…Specifically, engaging with e-cigarette content on social media can promote discussions about the health effects of using e-cigarettes among young people; thus, engagement with social media is an important activity to measure. From the limited research base examining engagement and e-cigarette social media messaging, research has found that young people shared memes when they were funny [2], and individuals engaged more with posts comparing e-cigarettes with cigarettes [17]. Other research examining e-cigarette industry sponsored posts and social media messaging have predominately focused on analyzing the content of posts [18,19] or characteristics of posts (e.g., likes, shares) [20].…”

Topics and Sentiment Surrounding Vaping on Twitter and Reddit During the 2019 e-Cigarette and Vaping Use–Associated Lung Injury Outbreak: Comparative Study

“…Results demonstrate that social media content can be used for overall infoveillance, and such data could inform future, individual-level detection models to identify at-risk posts and users. A systematic review conducted by Kwon and Park [ 32 ] found that sentiment regarding vaping tended to be more positive across social media sites, and previous research on Twitter has demonstrated that those who smoke are more likely to engage with misinformation about vaping [ 43 ]. Studies conducted on Reddit posts have illustrated health symptoms associated with vaping [ 44 ] and highlighted communities aimed to support those wanting to quit vaping [ 45 ].…”