Tweeting about public health policy: Social media response to the UK Government’s announcement of a Parliamentary vote on draft standardised packaging regulations

Abstract

Background Standardised tobacco packaging has been, and remains, a contentious policy globally, attracting corporate, public health, political, media and popular attention. In January 2015, the UK Government announced it would vote on draft regulations for the policy before the May 2015 General Election. We explored reactions to the announcement on Twitter, in comparison with an earlier period of little UK Government activity on standardised packaging. Methods We obtained a random sample of 1038 tweets in two 4-week periods, before and after the UK Government’s announcement. Content analysis was used to examine the following Tweet characteristics: support for the policy, purpose, Twitter-user’s geographical location and affiliation, and evidence citation and quality. Chi-squared analyses were used to compare Tweet characteristics between the two periods. Results Overall, significantly more sampled Tweets were in favour of the policy (49%) in comparison to those opposed (19%). Yet, at Time 2, following the announcement, a greater proportion of sampled tweets opposed standardised packaging compared to the period sampled at Time 1, prior to the announcement (p<0.001). The quality of evidence and research cited in URLs linked at Time 2 was significantly lower than at Time 1 (p<0.001), with peer-reviewed research more likely to be shared in positive Tweets (p<0.001) and in Tweets linking to URLs originating from the health sector (p<0.001). The decline in the proportion of positive Tweets was mirrored by a reduction in Tweets by health sector Twitter-users at Time 2 (p<0.001). Conclusions Microblogging sites can reflect offline policy debates and are used differently by policy proponents and opponents dependent on the policy context. Twitter-users opposed to standardised packaging increased their activity following the Government’s announcement, while those in support broadly maintained their rate of Twitter engagement. The findings offer insight into the public health community’s options for using Twitter to influence policy and disseminate research. In particular, proliferation of Twitter activity following pro-public health policy announcements could be considered to ensure pro-health messages are not overshadowed by anti-regulation voices.

Social Media Use for Health Purposes: Systematic Review

“…Third, user-generated social media posts can provide insights about the public's cognitive and behavioral responses to health-related issues. Studies have analyzed social media posts to understand public concerns and sentiments about ongoing disease outbreaks such as Zika [22] and COVID-19 [23], investigated public attitudes toward and actual implementation of recommended disease prevention actions [20,24], monitored public discussion about controversial health topics such as vaccination [25] and e-cigarettes [26], and gauged public support of health-related policies [27]. Assessing social media data to understand public responses to health issues not only yields results comparable to national survey data but also provides insights for health-related theoretical models [25].…”

Exploring the Twitter activity around the eighth meeting of the Conference of the Parties to the WHO Framework Convention on Tobacco Control

“…We adapted a coding framework used in earlier research on standardised packaging 2 and coded tweets in terms of content and sentiment. For content, we coded whether each tweet related to: (1) a specific TC policy such as tobacco taxation (hereafter this variable is referred to as 'TC-related'); (2) next-generation nicotine products (NGPs) (ie, vaping, e-cigarettes, other 'reducedrisk' nicotine products or 'tobacco harm reduction', hereafter labelled 'NGP-related') and (3) the WHO FCTC or TC more generally, that is, WHO FCTC ratification, governance or TC as a concept/sector ('FCTC-related').…”

“…Twitter data can provide insights into public policy debates such as sugar taxation 1 and standardised tobacco packaging, 2 including the stakeholders involved, alliances between groups and the arguments and evidence put forward to support different positions. Such data can help public health advocates better understand and inform policy debates, 1 2 and potentially also bring to light the role of self-interested parties such as corporations in shaping the discussion.…”

Developing an Automatic System for Classifying Chatter About Health Services on Twitter: Case Study for Medicaid

“…Consequently, there is considerably less research using the free-text data on social media for health-related tasks. Past studies closely related to ours have focused on analyzing sentiments toward attributes of health insurance plans [ 20 ] and social media users’ responses to public announcements about health policies [ 21 ]. However, to the best of our knowledge, there has been no near real-time automatic system that provides comprehensive data collection and analysis on social media chatter about health services and insurance coverage provided by large public insurers such as Medicaid and Medicare.…”