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Youth Access, Creation, and Content of Smokeless Tobacco ("Dip") Videos in Social Media
Abstract
Smokeless tobacco (SLT) use among white adolescent males has increased in recent years, and prevalence of SLT use among adolescent males exceeds that for smoking in several U.S. states. Recent reports have described the presence of cigarette-related content on social media Web sites popular among youth; however, little has been reported on SLT content.
The YouTube video search engine was searched for the popular SLT brand Skoal, and the first 50 search results were downloaded. Video statistics data were collected for and content analysis was performed on all videos featuring smokeless use (82%). Access to SLT YouTube videos by youth was also determined by assessing whether YouTube permits youth viewing and creation of SLT videos.
Mean number of views for videos analyzed was 15,422, and the most watched video had 124,276 views. Descriptions of SLT flavor/smell and social references/interactions were found in 48.8% and 63.4% of videos, respectively. By contrast, references to drug (nicotine) effects (12.2%) and public health messaging (9.8%) were less common. None of the SLT videos in the sample had restrictions that would block youth viewing. In addition, evidence of self-identified youth creating SLT videos was found for 13% of unique users in the sample.
YouTube does not restrict youth from creating or viewing "dip videos." Proactive efforts are needed to ensure that YouTube and other online media do not become influential vehicles for tobacco promotion to youth.
... Although these findings, along with regulatory efforts, have contributed to the decline of tobacco portrayal (mostly cigarettes) in cinema and on television since 1950 [3,4], emerging media such as the internet remain largely unregulated [5,6]. For example, many noncommercial internet materials generated by community members minimize or misrepresent the negative health consequences of tobacco use, either through omission (eg, not noting the negative health consequences [5,[7][8][9]), or through commission (eg, asserting that smoking is safe or even has health benefits [9][10][11]). The question guiding this research is: What is the likely effect of such tobacco-friendly communications disseminated informally on the internet? ...
... Although these findings, along with regulatory efforts, have contributed to the decline of tobacco portrayal (mostly cigarettes) in cinema and on television since 1950 [3,4], emerging media such as the internet remain largely unregulated [5,6]. For example, many noncommercial internet materials generated by community members minimize or misrepresent the negative health consequences of tobacco use, either through omission (eg, not noting the negative health consequences [5,[7][8][9]), or through commission (eg, asserting that smoking is safe or even has health benefits [9][10][11]). The question guiding this research is: What is the likely effect of such tobacco-friendly communications disseminated informally on the internet? ...
... There is a rising suspicion that online exposure to user-generated content on YouTube shapes young people's perceptions of tobacco [5][6][7][8][9][10][11][12][13][14][15]. There are at least three reasons for this concern. ...
Background:
Recent content analyses of YouTube postings reveal a proliferation of user generated videos with misleading statements about the health consequences of various types of nontraditional tobacco use (eg, electronic cigarettes; e-cigarettes).
Objective:
This research was aimed at obtaining evidence about the potential effects of YouTube postings about tobacco products on viewers' attitudes toward these products.
Methods:
A sample of young adults recruited online (N=350) viewed one of four highly viewed YouTube videos containing misleading health statements about chewing tobacco, e-cigarettes, hookahs, and pipe smoking, as well as a control YouTube video unrelated to tobacco products.
Results:
The videos about e-cigarettes and hookahs led to more positive attitudes toward the featured products than did control videos. However, these effects did not fully translate into attitudes toward combustive cigarette smoking, although the pipe video led to more positive attitudes toward combustive smoking than did the chewing and the hookah videos, and the e-cigarette video led to more positive attitudes toward combustive cigarette smoking than did the chewing video.
Conclusions:
This research revealed young people's reactions to misleading claims about tobacco products featured in popular YouTube videos. Policy implications are discussed.
... Next, additional accounts were identified by systematically searching social media content with keywords. The keywords to identify instances of online tobacco and e-cigarette marketing were systematically curated based on expert inputs and by reviewing relevant literature (49)(50)(51)(52)(53). Keyword-based Boolean searches, where keywords and hashtags, such as "e-cigarette" and "vape" were stitched together using special operators ("and, " "or") with company or brand names ("Geekvape" or "#Geekvape") were used to identify marketing instances. ...
... A standardized codebook was developed based on the published literature (49)(50)(51)(52)(53), expert inputs and initial data exploration. The full codebook is available in Supplementary Appendix 1. ...
Background
The use of e-cigarettes is proliferating globally, especially among youth and even children. Marketing is a known risk factor for e-cigarette initiation, yet little is known of e-cigarette marketing on social media in low- and middle-income countries. This study compares e-cigarette social media marketing in India, Indonesia, and Mexico, three such countries with different regulatory environments.
Methods
Instances of e-cigarette marketing on social media platforms were identified via the Tobacco Enforcement and Reporting Movement (TERM), a digital tobacco marketing monitoring system. Through systematic keyword-based searches, all tobacco marketing posts observed between 15 December 2021 and 16 March 2022 were included in the analysis. The final sample included 1,437 e-cigarette-related posts on Instagram, Facebook, Twitter, YouTube, and TikTok, which were systematically content analyzed by independent coders after inter-reliability (Cohen's Kappa K > 0.79) was established using a theory-derived codebook. The final data is represented in percentages and frequencies for ease of presentation.
Results
We observed e-cigarette marketing online in all countries studied, yet there was variation in the volume of marketing and types of accounts identified. In India, where e-cigarettes were comprehensively banned, we identified 90 (6%) posts; in Mexico, where e-cigarettes were partially restricted, 318 (22%) posts were observed; and in Indonesia, where there were no restrictions, 1,029 (72%) posts were observed. In both India and Mexico, marketing originated from retailer accounts (100%), whereas in Indonesia, it was primarily product brand accounts (86%). Across countries, e-cigarettes were mostly marketed directly to sell products (India: 99%, Indonesia: 69% and Mexico: 93%), though the sales channels varied. Product features, including e-liquid flavors, device colors and technical specifications, was the most prominent message framing (India: 86%; Mexico: 73%; Indonesia: 58%). Harm reduction messaging was most popular in Mexico (8%) and was not common in Indonesia (0.3%) or India (0%).
Conclusion
Our study provides important insights for tobacco control stakeholders on the evolving nature of e-cigarette marketing in low- and middle-income countries. It underscores the presence of e-cigarette marketing, including in countries where comprehensive regulations exist, and suggests the importance of continuous monitoring to keep up with industry practices and strengthen tobacco control stakeholder efforts to counter them.
... Substantial research indicates that ads for alcohol and nicotine including e-cigarettes and vaping devices currently target adolescents and encourage adolescent use (Biener & Siegel, 2000;Davis, Gilpin, Loken, Viswanath, & Wakefield, 2008;Gordon, Hastings, & Moodie 2010;Henriksen, Feighery, Schleicher, and Fortmann, 2008;Pechmann, Biglan, Grube, & Cody, 2012;Snyder, Milici, Slater, Sun, & Strizhakova, 2006). Ads for agerestricted products often persuade adolescents to use the products by conveying positive images of user groups (Pechmann & Knight, 2002;Seidenberg, Rodgers, Rees, & Connolly, 2012), with adolescents more susceptible to such influence than adults (Pollay et al., 1996;Seidenberg et al., 2012), and even very young adolescents affected (Harris, Gordon, MacKintosh, & Hastings, 2015;Stacy, Zogg, Unger, & Dent, 2004). Adolescents who desire to be older are especially vulnerable to advertisements for age-restricted products (Pezzuti, Pirouz, & Pechmann, 2015). ...
... Substantial research indicates that ads for alcohol and nicotine including e-cigarettes and vaping devices currently target adolescents and encourage adolescent use (Biener & Siegel, 2000;Davis, Gilpin, Loken, Viswanath, & Wakefield, 2008;Gordon, Hastings, & Moodie 2010;Henriksen, Feighery, Schleicher, and Fortmann, 2008;Pechmann, Biglan, Grube, & Cody, 2012;Snyder, Milici, Slater, Sun, & Strizhakova, 2006). Ads for agerestricted products often persuade adolescents to use the products by conveying positive images of user groups (Pechmann & Knight, 2002;Seidenberg, Rodgers, Rees, & Connolly, 2012), with adolescents more susceptible to such influence than adults (Pollay et al., 1996;Seidenberg et al., 2012), and even very young adolescents affected (Harris, Gordon, MacKintosh, & Hastings, 2015;Stacy, Zogg, Unger, & Dent, 2004). Adolescents who desire to be older are especially vulnerable to advertisements for age-restricted products (Pezzuti, Pirouz, & Pechmann, 2015). ...
Adolescents face exceptional challenges and opportunities that may have a lifelong impact on their consumption and personal and societal well‐being. Parents, community members (schools, and neighborhoods), and policymakers play major roles in shaping adolescents and influencing their engagement in consumption behaviors that are either developmentally problematic (e.g., drug use and unhealthy eating) or developmentally constructive (e.g., academic pursuits and extracurricular activities). In this paper, we discuss two main topics: (1) the challenges and opportunities that characterize adolescence, based primarily on research in epidemiology and neuroscience, and (2) the ways that parents, community members, and policymakers can facilitate positive adolescent development, based on research from many disciplines including marketing, psychology, sociology, communications, public health and education. Our goal is to summarize the latest scientific findings that can be used by various stakeholders to help adolescents navigate this turbulent period and become well‐adjusted, thriving adults. This article is protected by copyright. All rights reserved.
... For instance, YouTube has been used to understand unorthodox tobacco use methods, such as techniques on manipulating cigars [26]. YouTube videos are widely used to promote various tobacco products, including cigarettes [27,28], hookah [29], smokeless tobacco [30,31], cigars and little cigars [32], and e-cigarettes [20,22,[33][34][35][36]. For instance, vape pens have been promoted via music videos on YouTube, and these music videos have been viewed over 1.4 billion times in 24 months [37]. ...
... However, the high number of views and likes does suggest popularity. In fact, the view count for vape trick videos identified in this study was comparable with previous research on videos on e-cigarettes [22] and smokeless tobacco [30] identified on YouTube. ...
Background:
The ability to perform vape tricks (ie, blowing large vapor clouds or shapes like rings) using e-cigarettes appeals to youth. Vape tricks are promoted on social media, but the promotion of vape tricks on social media is not well understood.
Objective:
The aim of this study was to examine how vape tricks were promoted on YouTube to youth.
Methods:
Videos on vape tricks that could be accessed by underage youth were identified. The videos were coded for number of views, likes, dislikes, and content (ie, description of vape tricks, e-cigarette devices used for this purpose, video sponsors [private or industry], brand marketing, and contextual characteristics [eg, model characteristics, music, and profanity]).
Results:
An analysis of 59 sample videos on vape tricks identified 25 distinct vape tricks. These videos had more likes than dislikes (11 to 1 ratio) and a 32,017 median view count. 48% (28/59) of the videos were posted by industry accounts (27% [16/59] provaping organizations, 15% [9/59] online shops, and 3% [2/59] vape shops) and 53% by private accounts (55% [17/31] private users, 26% [8/31] vape enthusiasts, and 19% [6/31] YouTube influencers); 53% (31/59) of the videos promoted a brand of e-cigarette devices, e-liquids, or online/vape shops, and 99% of the devices used for vape tricks were advanced generation devices. The models in the videos were 80.2% (160/198) male, 51.5% white (102/198), and 61.6% (122/198) aged 18 to 24 years; 85% (50/59) of the videos had electronic dance music and hip hop, and 32% (19/59) had profanity.
Conclusions:
Vape trick videos on YouTube, about half of which were industry sponsored, were accessible to youth. Restrictions of e-cigarette marketing on social media, such as YouTube, are needed.
... What behaviours are promoted however depends on who is using it and the messages that are being shared. 15 Finally, in respect of mobile technology-whether through text-message-based communications, 16 location-based social media such as FourSquare 17 or smartphone applications 18the research on mobile utilization for health is robust. The results are promising for health interventions with results showing increased adherence to smoking cessation, 15 decreased drug use and better informed sexual health decision-making. ...
... 15 Finally, in respect of mobile technology-whether through text-message-based communications, 16 location-based social media such as FourSquare 17 or smartphone applications 18the research on mobile utilization for health is robust. The results are promising for health interventions with results showing increased adherence to smoking cessation, 15 decreased drug use and better informed sexual health decision-making. ...
Digital media usage is expanding enormously and is starting to be used as a public health intervention and communication tool. It has an ability to increase the reach of public health research and communication, as well as drive measurable behaviour change. But there is an absence of both deep and wide understanding of the opportunities within digital media, i.e. most people think only of Facebook and Twitter when they think of social media; smart, strategic planning for its widespread use is not common practice and rigorous evaluative studies of its effectiveness are few and far between.
This paper analyses the published literature on this topic and identifies the top 10 directions that use of digital media is likely to take in the medium term.
The analysis strongly supports the position that digital media needs to be taken seriously as a vehicle for public health activity in its own right and not merely as an adjunct to other campaigns.
Digital media will continue to develop and move from being an add-on to existing activity to being the major vehicle for significant elements of research, data collection and advocacy. It is important that public health leaders fully understand and engage in its development and use.
... All collated posts by youth were organized by entering in an Microsoft Excel sheet by identifying variables(key themes) based on the review of the literature. [25][26][27][28][29][30][31][32] Descriptive analysis of social media posts, as observed in prior studies, was utilized to perform data analysis. 32,33 For posts where tobacco was promoted, apriori variables that were considered for evaluation were the type of post (like photo or video), SNS medium on which it was seen (Facebook, YouTube, Instagram, Twitter, other), form of tobacco (cigarette, chewing, hookah, e-cigarette, smoking pipe, etc.), presence of celebrity (yes or no), gender of the celebrity or model (male or female), year of uploading the post, use of cartoon characters (yes or no), display of health warnings (yes or no), number of views on a post, social context of post (type of message delivered in the post i.e. warn against tobacco use or glamorize tobacco use), tobacco use promoted through (text, pictures or both), influencer name, likes and followers on their page. ...
Background
Social networking sites (SNS) have become the contemporary platform of choice for advertising, promoting, sponsoring, boosting and expanding tobacco marketing. A youth-led campaign was conducted to (i) identify and collate violations of tobacco advertisement, promotion, and sponsorship on SNS; and (ii) undertake content analysis of the collated violations.
Methods
After a series of capacity-building webinars aimed at empowering youths, they were tasked with collating posts (photos and videos) that showcased the promotion and sale of tobacco products online. Additionally, the youth identified relevant hashtags used to promote tobacco.
Results
The youth identified 748 posts (photos and videos) on SNS where tobacco was being promoted. Most of these posts (84.7%) promoted the ‘smoking form’ of tobacco. Renowned celebrities and influencers with massive followership actively endorsed tobacco products. The youth identified 148 pages that were involved in selling tobacco online. Instagram (62.7%) accounted for the majority, followed by Facebook (23.7%). The most commonly available forms of tobacco in these online stores were ‘smoked forms’ (73.5%). In their efforts, the youth collated 1412 hashtags related to tobacco promotion. The most commonly reported hashtags were #smoking and #hookah. The maximum numbers of tobacco posts were for #vape (296 million) and #smoke (218 million).
Conclusions
There is an urgent need to revise Section 5 of “ The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act, 2003 ” to broaden the coverage of tobacco advertising, promotion, and sponsorship (TAPS) prohibition on all internet-based platforms including SNS to protect Indian youth.
... To our knowledge, this is the first media content analysis studying the enforcement component of SLT control in the LMIC context. Earlier content analyses were conducted in high-income countries (HICs) and studied SLT in relation to advertising and promotion among youth and adults in print and social media [32][33][34][35][36][37]. The main findings of our study showed that gutka ban enforcement is communicated to the public using a variety of arguments and visuals embedded in the actors, processes, and outcomes as shown in Fig 5. ...
Smokeless tobacco (SLT) products like gutka and paan masala are a growing public health crisis in India. Despite enacting a ban—the highest form of regulation—little is known about implementation progress. The purpose of this study was to look at how enforcement of gutka ban is covered in Indian news media and if media is a reliable source of data. We conducted a content analysis of online news reports (n = 192) from 2011 to 2019. News characteristics such as name and type of publication, language, location, slant and beat coverage, visuals, and administrative focus were quantified. Similarly, news contents were inductively coded to examine dominant themes and the implementation landscape. We found that coverage was initially low but increased after 2016. Overall, news reports were in favor of the ban. Five leading English newspapers covered the majority of the ban enforcement reports. Prominent themes like consumption, health hazards, tobacco control responses, impact on livelihoods, and illicit trade were drawn from the textual analysis as the main arguments in relation to the ban. Gutka is largely seen as an issue of crime reflected by the contents, sources, and frequent use of pictures depicting law enforcement. The interconnected distribution channels of the gutka industry hindered enforcement, highlighting the need to study the complexities of regional and local SLT supply chains.
... Tobacco control researchers have also documented YouTube content related to other tobacco products popular with youth, such as hookah (Carroll, Shensa, & Primack, 2013), cigars and cigarillos (Richardson & Vallone, 2014), and smokeless tobacco or "dip" (Seidenberg, Rodgers, Rees, & Connolly, 2012). The videos featuring cigars and cigarillos had been viewed almost six million times at the time of the study, were most often viewed by males, and several of the videos were most often viewed by 13-17-year-olds. ...
p>Misinformation studies have focused on traditional news formats, overlooking prevalent visual forms such as political memes. However, if citizens systematically respond differently to claims conveyed by memes, their effects on the broader information ecosystem may be underestimated. This study (N = 598) uses a 2 (partisan news/meme) X 2 (oppositional/congenial) design to examine perceptions of political memes’ influence on self and others, and the format’s effect on willingness to engage in corrective discussion. Results indicate that meme format enhances individuals’ tendency to see messages as less influential on oneself than on others, and individuals are less likely to correct claims presented in meme format. This decrease in corrective intent is mediated by the decrease in perceived influence over self. These findings have practical implications for those combating inaccurate claims in the public sphere, and call attention to the role format differences may play in the psychological processes underlying political discussion as it becomes increasingly mediated and visual.</p
... The relative efficacy of social media advertising leading to firearm sales is unknown: most manufacturers are privately owned companies, so documents on advertising expenditures and company profitability are not public [2,3]. However, there is an emerging, but rich, body of research on the use of social media, particularly YouTube, for spreading tobacco and e-cigarette advertising [46][47][48][49][50][51]. Given there are restrictions on legal channels for advertising, tobacco companies have increasingly turned to internet promotion [52]. ...
Background:
Although gun violence has been identified as a major public health concern, the scope and significance of internet gun advertising is not known.
Objective:
This study aimed to quantify the characteristics of gun advertising on social media and to compare the reach of posts by manufacturers with those of influencers.
Methods:
Using a systematic search, we created a database of recent and popular Twitter and YouTube posts made public by major firearm manufacturers and influencers. From our sample of social media posts, we reviewed the content of the posts on the basis of 19 different characteristics, such as type of gun, presence of women, and military or police references. Our content analysis summarized statistical differences in the information conveyed in posts to compare advertising approaches across social media platforms.
Results:
Sample posts revealed that firearm manufacturers use social media to attract audiences to websites that sell firearms: 14.1% (131/928; ±2.9) of Twitter posts, 53.6% (228/425; ±6.2) of YouTube videos, and 89.5% (214/239; ±5.1) of YouTube influencer videos link to websites that facilitate sales. Advertisements included women in efforts to market handguns and pistols for the purpose of protection: videos with women included protection themes 2.5 times more often than videos without women. Top manufacturers of domestic firearms received 98 million channel views, compared with 6.1 billion channel views received by the top 12 YouTube influencers.
Conclusions:
Firearm companies use social media as an advertising platform to connect viewers to websites that sell guns. Gun manufacturers appropriate YouTube servers, video streaming services, and the work of YouTube influencers to reach large audiences to promote the widespread sale of consumer firearms. YouTube and Twitter subsidize gun advertising by offering server and streaming services at no cost to gun manufacturers, to the commercial benefit of Google and Twitter's corporate ownership.
... When snus has been a topic, it has usually been studied as part of the broader concept of "smokeless tobacco." 22,23 In a study of US news coverage of smokeless tobacco in the period 2006-2010, the researchers set out to identify issues related to snuff, risk references, and perspectives/bias ("slants") in the major national and regional newspapers and news wires. 24 The study showed that the majority of stories were negative and critical towards smokeless tobacco. ...
Background
In a context where snus is a legal product, its advertising is prohibited and its prevalence of use has been on the rise among adolescents and young adults, the aim of this paper is to identify the extent of snus coverage in Norwegian newspapers and the themes and values communicated about snus therein from 2002 to 2011.
Data and methods
All major Norwegian newspapers were scanned for articles with “snus” (and relevant connectors) in headings, ingresses and/or pictures/captions as search criteria. Using the Retriever media monitoring service as a database, the search returned 943 unique articles, which were subjected to quantitative content analysis.
Results
The number of articles per year increases over the period, while their average length decreases slightly. Thematically, the greatest attention is on extent of “snus use” (occurring in 52.7% of the articles), and then more equally divided between “tobacco policy” (24.5%), “economy/markets” (29.1%) and “health” (28.7%). 48.6% of the articles are “neutral/mixed” in respect of framing, 28.1% are “negative”, and only 20.7% are “positive” in tone. Articles about tobacco policy are more often negative, while articles on economic factors are more often positive. Articles on health are usually negatively focused, or neutral/mixed.
Conclusion
The slight predominance of negative and/or neutral/mixed articles indicates that the newspaper coverage does not glamorize the snus product. However, the sheer amount of (and growth in) articles over time, as well as positive articles available for selective exposure and perception, may nevertheless have contributed to a normalization of snus use.
... Many other studies have also performed keywords search to extract relevant videos on YouTube. (Pandey et al., 2010;Tian, 2010;Chou et al., 2011;Richardson et al., 2011;Richardson and Vallone, 2012;Seidenberg et al., 2012;Fernandez-Luque et al., 2011b) Carneiro and Mylonakis (2009) and metaphorical relations (Neuman et al., 2012) are also leveraged to automatically construct lexicons of interest. ...
Social media websites are increasingly used by the general public as a venue to express health concerns and discuss controversial medical and public health issues. This information could be utilized for the purposes of public health surveillance as well as solicitation of public opinions. In this thesis, I developed methods to extract health-related information from multiple sources of social media data, and conducted studies to generate insights from the extracted information using text-mining techniques. To understand the availability and characteristics of health-related information in social media, I first identified the users who seek health information online and participate in online health community, and analyzed their motivations and behavior by two case studies of user-created groups on MedHelp and a diabetes online community on Twitter. Through a review of tweets mentioning eye-related medical concepts identified by MetaMap, I diagnosed the common reasons of tweets mislabeled by natural language processing tools tuned for biomedical texts, and trained a classifier to exclude non medically-relevant tweets to increase the precision of the extracted data. Furthermore, I conducted two studies to evaluate the effectiveness of understanding public opinions on controversial medical and public health issues from social media information using text-mining techniques. The first study applied topic modeling and text summarization to automatically distill users' key concerns about the purported link between autism and vaccines. The outputs of two methods cover most of the public concerns of MMR vaccines reported in previous survey studies. In the second study, I estimated the public's view on the ac{ACA} by applying sentiment analysis to four years of Twitter data, and demonstrated that the the rates of positive/negative responses measured by tweet sentiment are in general agreement with the results of Kaiser Family Foundation Poll. Finally, I designed and implemented a system which can automatically collect and analyze online news comments to help researchers, public health workers, and policy makers to better monitor and understand the public's opinion on issues such as controversial health-related topics.
... Studies who have performed content analyses on social media, especially YouTube and Facebook, have found that tobaccorelated materials are ample and dominantly positive in its portrayal of tobacco use. [38][39][40][41][42][43][44][45][46] One of the potential reasons behind this overabundance of tobacco-related content on social media is that after legislative bans on TAPS came into effect, the tobacco industries pushed to use social media as a tool to keep their products in the minds of current and potential tobacco consumers. 29 47 This tobacco content on social media has a great negative impact on the behaviour of youth and young adults. ...
Objective: To determine whether the odds of being a smoker differ based on social media use and social interactions among urban university students in Bangladesh.
Hypothesis: Social media use and social interactions influence the smoking behaviour of Bangladeshi university students, particularly in starting and maintaining cigarette smoking.
Design and setting: A cross-sectional study using mixed methods on 600 student smokers and non-smokers recruited from two public and two private universities in Dhaka, Bangladesh, a lower middle-income country with limited resources. Exclusion criteria were those who did not use any form of social media and PhD students.
Results: Odds of smoking were significantly higher for those who socialised more than 4 hours/day (p<0.05; OR 1.75; 95% CI 1.12 to 2.75) and typically at night (p<0.05; OR 2.80; 95% CI 1.95 to 4.00). Odds of smoking were also higher for those who liked (p<0.05; OR 4.85; 95% CI 3.32 to 7.11), shared (p<0.05; OR 20.50; 95% CI 13.02 to 32.26) and followed (p<0.05; OR 2.88; 95% CI 1.36 to 6.11) tobacco-related content on social media. Qualitative analysis resulted in emergent themes of smokers imitating tobacco-related photos or videos seen on social media and peers as an influence for smoking initiation. Conclusion: This study suggests social media and social interactions may influence smoking behaviour in university students in Dhaka, Bangladesh. Future research should continue to investigate the roles social media and social interaction have on smoking in order to explore social media-based smoking cessation interventions or dissemination of smoking health hazards through social media.
... Of those, a final sample of 66 videos that have more than 10 K views as of September 1, 2019 were analyzed to focus on the content that has been exposed to more audiences. The cutline was set as 10 K as the number represents higher popularity; the median views of YouTube videos related with novel tobacco products (e.g., Dip, hookah) were 10 K -15 K (Carroll et al., 2013;Seidenberg et al., 2012). YouTube accepted a channel to the YouTube Partner Program (YPP), when it had more than 10 K views (BBC News, 2017). ...
Background: Recently, the FDA authorized sales of another novel tobacco products - heated tobacco products (HTPs), electronic devices that heat tobacco and produce nicotine aerosols for inhalation, amid continuous increases of novel tobacco product usage among youth.
Objective: This research examines age restrictions and warnings on minor viewing or tobacco risk in popular HTP videos on YouTube in response to concerns on HTPs attracting youth and the dominance of pro-tobacco content on social media.
Method: Trained researchers coded the presence of age-restriction requested by the uploader, minor viewing warning (any statement/graphic warning minors’ access to the video in title, thumbnail, short description, the beginning of the video, and channel description) and health risk warning (any statement informing any health risk of tobacco use) in 66 HTP videos that have more than 10K views. The association between such presence and video/creator features was assessed.
Results: There was a steady increase of popular HTP videos from 2014 to 2019. The 66 HTP videos generated 5.2 million views. Only three videos were age-restricted. Of the videos with no age-restriction, 38% showed actual use of HTPs. Six videos disclosed a warning on minor viewing. Four videos showed a warning on any type of tobacco risk, and only one of those contained specific information about the risks of HTPs. Videos by three types of pro-tobacco creators consisted of more than 80% and the total channel subscribers were more than 2.1 million.
... [216][217][218][219][220]), and studies of the quality of information conveyed through social media, including whether the information aligned with health recommendations (e.g. [210,221,222]). For example one study examined how responsibility and solutions for obesity are framed within YouTube videos [215]. Other studies considered how users talk about issues on social media (e.g. ...
Background:
Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area.
Methods:
We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies.
Results:
Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work.
Conclusions:
The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.
... Social marketing as a consumer-oriented approach leads to a change in consumer behavior with the help of social media. Internet marketing through corporate websites, direct marketing through campaigns on websites, viral marketing through Web 2.0 leads to a change in consumer behavior (Thackeray et al., 2008;Thackeray & Neiger 2009;Smailhodzic et al., 2016;Seidenberg et al., 2012). Also, social media has a great influence on the management of the tourism and hospitality system and the decision of travelers (De Moya & Jain, 2013; Zeng & Gerritsen, 2014; Leung et al., 2013;Balatsoukas et al., 2015). ...
Social media has grown very quickly and has affected all dimensions of the world’s community.
The purpose of this article is to review valid articles on the relationship between social media and
promotion using manual and bibliometrics analysis methods and identify top themes in these articles.
We review the papers published between 2007 and the first month of 2019 in Scopus. 1,840
articles were published in the mentioned period. In this article, we review various charts including
word dynamics, the contributions of different countries, country scientific production, corresponding
author's country, the frequency distribution of sources, collaboration network and country
collaboration map. The study indicates that Canada, Australia and France were the most productive
countries in this area.
... Evidence has shown that substance use frequently is portrayed and discussed on social media, often in positive terms, and that young people easily may access and engage with these posts (Egan & Moreno, 2011;Morgan, Snelson, & Elison-Bowers, 2010;Myslín, Zhu, Chapman, & Conway, 2013;Seidenberg, Rodgers, Rees, & Connolly, 2012). This finding is meaningful when considering tobacco use because, according to social cognitive theory (Bandura, 2001;Stefanone, Lackaff, & Rosen, 2010), people-especially young people-are strongly influenced by peers or others in social media and reality shows who "look" like they could be peers (Stefanone et al., 2010). ...
Our research provides social scientists with areas of inquiry in tobacco-related health disparities in young adult women and opportunities for intervention, as Instagram may be a powerful tool for the public health surveillance of smoking behavior and social norms among young women. Social media has fundamentally changed how to engage with health-related information. Researchers increasingly turn to social media platforms for public health surveillance. Instagram currently is one of the fastest growing social networks with over 53% of young adults (aged 18-29) using the platform and young adult women comprise a significant user base. We conducted a content analysis of a sample of smoking imagery drawn from Instagram’s public Application Programming Interface (API). From August 2014 to July 2015, 18 popular tobacco- and e-cigarette-related text tags were used to collect 2.3 million image posts. Trained undergraduate coders (aged 21-29) coded 8,000 images (r = .91) by type of artifact, branding, number of persons, gender, age, ethnicity, and the presence of smoke. Approximately 71.5% of images were tobacco-relevant and informed our research. Images of cigarettes were the most popular (49%), followed by e-cigarettes (32.1%). “Selfies while smoking” was the dominant form of portrait expression, with 61.4% of images containing only one person, and of those, 65.7% contained images of women. The most common selfie was women engaged in “smoke play” (62.4%) that the viewer could interpret as “cool.” These “cool” images may counteract public health efforts to denormalize smoking, and young women are bearing the brunt of this under-the-radar tobacco advertising. Social media further normalizes tobacco use because positive images and brand messaging are easily seen and shared, and also operates as unpaid advertising on image-based platforms like Instagram. These findings portend a dangerous trend for young women in the absence of effective public health intervention strategies.
... Web traffic on sites promoting ST (snuff) rose between 2011 and 2014 [39]. ST was also promoted in online video/banner tobacco adverts [40] and in YouTube videos [41,42]. Advertising ST over the Internet, in print media and at the points of sale enhances ST curiosity [43], experimentation [44] and uptake among youths [45,46]. ...
Background
Globally, over 300 million people consume diverse smokeless tobacco (ST) products. They are addictive, cause cancer, increased cardiovascular mortality risks and poor pregnancy outcomes. Purpose of ReviewTo identify gaps in implementing key ST demand-reduction measures, focused literature reviews were conducted and findings synthesized according to relevant WHO Framework Convention on Tobacco Control (FCTC) Articles. Recent FindingsThe literature supports implementation of ST demand-reduction measures. For taxation, labelling and packaging, most administrations have weaker policies for ST than cigarettes. Capacity to regulate ST contents and offer cessation support is lacking. There is poor compliance with bans on ST advertising, promotion and sponsorship. SummaryThe literature on implementation of WHO FCTC for ST is limited. Although strengths of ST demand-control activities are currently identifiable from available literature, full implementation of FCTC is lacking. A wider evidence-based response to WHO FCTC is proposed, particularly for countries facing the greatest disease burdens.
... While the presence of protobacco messages on social media is well-documented, thus far, research has been limited to either small, descriptive studies [9,21], or studies examining overall characteristics or trends of tobacco-related social media communications [22,23]. To date, only one study has examined the relationship between exposure to tobacco-related social media and tobacco use behaviors [24]. ...
Purpose
Little is known about the nature and extent of adolescents' exposure to tobacco- and e-cigarette–related communications on social media. In this study, we describe the prevalence and correlates of youth exposure and engagement with tobacco- and e-cigarette–related social media.
Methods
Data are from the baseline survey of the Texas Adolescent Tobacco and Marketing Surveillance system, a cross-sectional sample of sixth, eighth, and 10th graders (n = 3907, N = 461,097). Weighted logistic regression models were used to examine associations between demographic characteristics, sensation seeking, tobacco use, and exposure and engagement with tobacco-related social media.
Results
Overall, 52.5% of students reported exposure to tobacco-related social media in the past month, whereas < 6% reported engagement. Exposure and some forms of engagement were more common among high school students, girls, those with friends who use tobacco, and high sensation seekers (p < .05). The odds of exposure were significantly higher among students susceptible to combustible tobacco (adjusted odds ratio [AOR] = 1.71, p < .05), e-cigarettes (AOR = 2.10, p < .01), and both combustible tobacco and e-cigarettes (AOR = 2.24, p < .001). The odds of engaging with social media was higher among those who were susceptible to, had ever, or currently use both combustible tobacco and e-cigarettes (AOR = 2.10–3.46, p < .05).
Conclusions
About 1 in every 2 adolescents in Texas are exposed to tobacco-related social media. Adolescents who are susceptible to or use e-cigarettes and/or combustible tobacco are exposed to and engage with tobacco-related social media more than their peers. Social media appears to be an important venue when targeting vulnerable youth in prevention campaigns.
... Although many agree that online advertising is an important target for regulations and counter-marketing efforts (Freeman, 2012;Ribisl & Jo, 2012), the extent of online tobacco marketing exposure is poorly understood. Thus far, research has been limited to descriptive studies (Bromberg et al., 2012;Hua, Yip, & Talbot, 2013;Seidenberg, Rodgers, Rees, & Connolly, 2012;Wackowski, Lewis, & Delnevo, 2011), studies that examine overall trends in online marketing (Cavazos-Rehg, Krauss, Spitznagel, et al., 2014;Richardson et al., 2014a) or qualitative content analyses (Cole-Lewis, Pugatch, Sanders, et al., 2015;Emery et al., 2014;Myslín, Zhu, & Conway, 2013) rather than quantifying specific exposure. ...
Introduction:
Existing measures of tobacco marketing and messaging exposure are limited, relying on recall, recognition, or proxy measures. This study aimed to determine the feasibility and reliability of a mobile application for the measurement of tobacco and e-cigarette marketing and message exposure using ecological momentary assessment (EMA).
Methods:
Young adults from Austin, TX (n=181, ages 18-29) were instructed to use a mobile application to record all sightings of marketing or social media related to tobacco (including e-cigarettes) in real-time for 28days (Event EMAs). Tobacco product use and recall of message encounters were assessed daily using an app-initiated EMA (Daily EMAs).
Results:
The mobile app was a feasible and acceptable method to measure exposure to tobacco messages. The majority of messages (45.0%) were seen on the Internet, and many were user-generated. Thirty-day recall of messages at baseline was poorly correlated with messages reported via Event EMA during the study period; however, the correlation between post-study 30-day recall and Event EMA was much stronger (r=0.603 for industry-sponsored messages, r=0.599 for user-generated messages). Correlations between Daily EMAs and 30-day recall of message exposure (baseline and post-study) were small (baseline: r=0.329-0.389) to large (post-study: r=0.656-0.766).
Conclusions:
These findings suggest that EMA is a feasible and reliable method for measuring tobacco message exposure, especially given the prevalence of messages encountered online and on social media. Recall measures are limited in their ability to accurately represent marketing exposure, but might be improved by a period of priming or clearer response categories.
... For instance, Tobacco Company marketing has appeared on Facebook, Twitter, and YouTube [31][32][33]. Moreover, user-generated (non-industry) content encouraging tobacco use has been described [34,35]. Frequent social media use may expose the LGB community to tobacco-promoting content online, which may be contributing to high smoking prevalence. ...
Background
: Smoking rates among lesbian, gay, and bisexual (LGB) people significantly exceed that of heterosexuals. Media interventions are an important part of tobacco control efforts, but limited information is available on LGB people's media use.Methods: A nationally representative sample of 12,900 U.S. adults completed an online questionnaire assessing media use, smoking status, and demographic information. Multivariable logistic regression was used to assess relationships between media use with sexual orientation and smoking status.Results: A total of 590 (4.6%) respondents identified as LGB, of which 29% were smokers. Regardless of sexual orientation and smoking status, the Internet was the most popular media channel used, followed by television and radio. LGB respondents had significantly greater odds of having accounts on social media websites, accessing Facebook daily, and being a frequent Internet user, compared to heterosexual respondents. Similar media use was found between smokers and non-smokers, but smokers had greater odds of being frequent television viewers and frequent Internet users, compared to non-smokers.Conclusions: Compared to heterosexuals, LGB respondents reported greater use of the Internet, especially social media. Media campaigns targeting LGB populations can maximize reach by utilizing social media alongside traditional media channels.
... In a recent survey of teenagers, approximately 85% named YouTube their favorite source for video content (Defy Media, 2016). Content analyses of YouTube demonstrate that the tobacco-related material is not only plentiful, but also predominately positive in its portrayal of tobacco use (Bromberg, Augustson, & Backinger, 2012;Carroll, Shensa, & Primack, 2012;Davis et al., 2009;Elkin et al., 2010;Forsyth & Malone, 2010;Kim, Paek, & Lynn, 2010;Luo et al., 2014;Paek, Kim, Hove, & Huh, 2014;Richardson & Vallone, 2014;Seidenberg, Rodgers, Rees, & Connolly, 2012). Included in this content are videos featuring young people smoking, a problematic behavior because modeling of smoking in popular media has been shown to increase tobacco consumption (Jamieson & Romer, 2014;Sargent, Beach, & Adachi-Mejia et al., 2005;Villanti, Boulay, & Juon, 2011). ...
YouTube, a popular online site for user-generated content, is emerging as a powerful source of peer modeling of smoking. Previous research suggests that in counteracting such influence, health messages may inadvertently increase the perceived prevalence of drug use (a descriptive norm) without reducing its acceptability (injunctive norm). This research tested the ability of health messages to reduce the social acceptability of peer smoking on YouTube despite enhancing its perceived prevalence. In an online experiment with 999 adolescents, participants were randomly assigned to view one of two videos: (a) a mosaic displaying a variety of YouTube videos of adolescents smoking followed by a message about the mortality risk to those smokers, or (b) a control video on a health topic unrelated to smoking. Although exposure to the adolescent YouTube smokers increased perceived prevalence among some participants, it simultaneously increased beliefs about smoking’s adverse health outcomes and negative attitudes toward smoking, effects that were associated with reductions in injunctive norms of social acceptability. Interventions that communicate the severity and scope of health risks associated with smoking may undercut the descriptive normative effects of peer modeling of smoking on social media sites such as YouTube.
... Prior research has shown that both media and peers are strong influences on youth substance use behaviors and attitudes, and YouTube is known to be a popular social media site among teens (Allen et al., 2012;Mander, 2015;Salimian et al., 2014;Wasserman, 2013;Waylen et al., 2015), therefore the accessibility of edibles-related videos to underage youth is of concern. Specifically, we found that, similar to other studies about substance use on YouTube (Barry et al., 2015;Huang, Kornfield, & Emery, 2016;Seidenberg, Rodgers, Rees, & Connolly, 2012;Winpenny, Marteau, & Nolte, 2014), the majority of videos about edibles was accessible to underage viewers. Furthermore, the content of most of the videos appeared to encourage edibles' use. ...
Background:
Interest in marijuana edibles has increased as perceptions of harm from marijuana have decreased. Media and peer influences impact youth substance use, and YouTube is the most popular video-sharing website. No studies have examined the content and accessibility of YouTube videos related to marijuana edibles.
Objectives:
To describe the messages conveyed to viewers in YouTube videos about edibles and determine their accessibility to youth.
Methods:
On June 12, 2015, we searched YouTube for videos about marijuana/cannabis/weed edibles. A total of 51 videos were coded for presence of an age restriction, purpose(s) of the videos, consumption of edibles during the video, effects, and safety concerns.
Results:
Total views across all 51 videos were >9 million. Only 14% (7/51) were restricted to viewers over the age of 18 years. Over half (27/51, 53%) were informative videos, most (20/27, 74%) teaching how to make edibles, and 37% (19/51) were entertaining videos. Someone consumed an edible in 31% (16/51) of the videos, and the type of high was mentioned in 51% (26/51) of the videos, including delayed (18/26, 69%) or intense high (13/26, 50%). Fifty-five percent (28/51) mentioned delta-9-tetrahydrocannabinol potency or dosage. Only 10 of these (36%) presented this information specifically as a warning to prevent adverse effects. Conclusions/Importance: Edibles-related videos are easily found on YouTube, often instructing how to bake your own edibles and lacking information needed for safe consumption, and most are not age-restricted. Videos showing how to make edibles or presenting edibles use in an entertaining way that could influence youth to initiate use.
... Social media platforms offer forums for pro-substance use messages that are largely unregulated (Jernigan and Rushman 2014), and companies may take advantage of the unique pressures in these settings. For example, adolescents' desire for peer social approval creates pressure to develop pro-drinking online identities (Ridout et al. 2012) and may increase the appeal of niche online communities that support unhealthy substance use decisions, as observed in YouTube communities posting videos about their use of smokeless tobacco (Seidenberg et al. 2012). Anticipating these shifting social media influences is a challenge, as is predicting the rise of new substance use technologies. ...
Adolescents' media environment offers information about who uses substances and what happens as a result-how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents' (n = 817, 48 % female, 64 % white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents' media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents' media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents' interest in alcohol and tobacco use.
... Tobacco control researchers have also documented YouTube content related to other tobacco products popular with youth, such as hookah (Carroll, Shensa, & Primack, 2013), cigars and cigarillos (Richardson & Vallone, 2014), and smokeless tobacco or "dip" (Seidenberg, Rodgers, Rees, & Connolly, 2012). The videos featuring cigars and cigarillos had been viewed almost six million times at the time of the study, were most often viewed by males, and several of the videos were most often viewed by 13-17-year-olds. ...
The near-ubiquitous use of social media among adolescents and young adults creates opportunities for both corporate brands and health promotion agencies to target and engage with young audiences in unprecedented ways. Traditional media is known to have both a positive and negative influence on youth health behaviours, but the impact of social media is less well understood. This paper first summarises current evidence around adolescents’ exposure to the promotion and marketing of unhealthy products such as energy dense and nutrient poor food and beverages, alcohol, and tobacco on social media sites such as Facebook, Twitter, Instagram and YouTube. We explore emerging evidence about the extent of exposure to marketing of these harmful products through social media platforms and potential impacts of exposure on adolescent health. Secondly, we present examples of health-promoting social media campaigns aimed at youth, with the purpose of describing innovative campaigns and highlighting lessons learned for creating effective social media interventions. Finally, we suggest implications for policy and practice, and identify knowledge gaps and opportunities for future research.
... This aligns with constructs of social learning theory (Bandura and McClelland 1977), whereby people, especially those young in age, are influenced by others who model a behavior (i.e., substance use). Research has shown that young people can easily view and interact with substance use content on social media (Cavazos-Rehg et al. 2015a, b;Cranwell et al. 2015;Seidenberg et al. 2012;Winpenny et al. 2013). Not only is substance use frequently discussed on social media sites, but the dialog is generally driven by normalizing and pro-use messages (Egan and Moreno 2011;Moreno et al. 2009;Morgan et al. 2010;Myslin et al. 2013). ...
Instagram is a highly visual social networking site whose audience continues to grow, especially among young adults. In the present study, we examine marijuana-related content on Instagram to better understand the varied types of marijuana-related social networking occurring on this popular social media platform. We collected 417,561 Instagram posts with marijuana-related hashtags from November 29 to December 12, 2014. We assessed content of a random sample (n = 5000) of these posts with marijuana-related hashtags. Approximately 2136 (43 %) were explicit about marijuana and further analyzed. Of the 2136 marijuana-related posts, images of marijuana were common (n = 1568). Among these 1568 marijuana images, traditional forms (i.e., buds/leaves) were the most common (63 %), followed by some novel forms of marijuana, including marijuana concentrates (20 %). Among the 568 posts that displayed marijuana being ingested, 20 % showed someone dabbing marijuana concentrates. Marijuana-related advertisements were also observed among the 2136 marijuana-related posts (9 %). Our findings signal the promotion of marijuana use in its traditional plant-based form; trendy and novel modes of marijuana ingestion were also endorsed. This content along with the explicit marketing of marijuana that we observed on Instagram have potential to influence social norms surrounding marijuana use.
... Health professionals need to understand video messages related to health, including tobacco initiation and maintenance of use (Charlesworth & Glantz, 2005;Sargent et al., 2005). Studies have examined tobaccorelated health video messages on YouTube (Carroll, Shensa, & Primack, 2013;Seidenberg, Rodgers, Rees, & Connolly, 2012). Additionally, YouTube videos have been analyzed to compare puff and exhalation duration of electronic nicotine delivery system use and conventional cigarettes (Hua, Yip, & Talbot, 2013) and the portrayal of e-cigarette messages (Luo, Zheng, Zeng, & Leischow, 2014), but studies have not focused specifically on ecigarette videos related to health effects. ...
Background:
This study was conducted to assess the quantity, quality, and reach of e-cigarette health effects YouTube videos, and to quantify the description of positive and negative e-cigarette health effects and promotional content in each video.
Method:
Searches for videos were conducted in 2015 using the YouTube search engine, and the top 20 search results by relevance and view count were identified. Videos were classified by educational/medical news, advertising/marketing, and personal/testimonial categories. A coding sheet was used to assess the presence or absence of negative and positive health effects, and promotional content.
Results:
Of the 320 videos retrieved, only 55 unique videos were included. The majority of videos (46.9%) were educational/medical/news, 29.7% were personal/testimonial, and 23.4% were advertising/marketing. The three most common negative health effects included discussing nicotine, e-cigarettes not being FDA regulated, and known and unknown health consequences related to e-cigarette use. The top positive health effects discussed were how e-cigarettes can help individuals quit smoking, e-cigarettes are healthier than smoking, and e-cigarettes have no smoke or secondhand smoke exposure.
Conclusions:
It is critical to monitor YouTube health effects content and develop appropriate messages to inform consumers about the risks associated with use while mitigating misleading information presented.
... In particular, a lot of promotional efforts have been made to use this new online platform for the marketing of tobacco products, including traditional cigarettes as well as electronic cigarettes (Freeman, 2012;Freeman & Chapman, 2007;Richardson, Ganz, & Vallone, in press;Richardson, Vettese, Sussman, Small, & Selby, 2011). Given the ease of access and use of YouTube, particularly by young generation, the demand has arisen to appropriate this new site for pro-health causes and understand audience feedback (Seidenberg, Rodgers, Rees, & Connolly, 2012). Therefore, the current study took the case of an antismoking campaign by the CDC on YouTube and used social media assessment metrics to evaluate public response to its campaign videos. ...
... Examining social media interactions has proven useful for understanding public attitudes and perceptions surrounding health topics [8], such as smokeless tobacco use [9] and vaccinations [10]. Social media is unique from and a complement to other forms of self-reported data, including ecological momentary assessment and national surveys. ...
Social media interactions can inform public health risk perceptions. While research has examined the risk relationships between obesity and cancer, public attitudes about their associations remain largely unknown. We explored how these constructs were discussed together on two social media platforms. Publicly accessible Facebook and Twitter posts from a 2-month period in 2012 containing references to obesity ("obese/obesity," "overweight," and "fat") and cancer-related words were extracted (N = 3702 posts). Data cleaning yielded a final set of 1382 posts (Facebook: N = 291; Twitter: N = 1091). Using a mixed-methods approach, themes were inductively generated, and sentiment valence, structural elements, and epistemic stance were coded. Seven relational themes emerged: obesity is associated with cancer (n = 389), additional factors are associated with both obesity and cancer (n = 335), obesity causes cancer (n = 85), cancer causes obesity (n = 6), obesity is not linked to cancer (n = 13), co-occurrence (n = 492), and obesity is valued differently than cancer (n = 60). Fifty-nine percent of posts focused on an associative or causal link between obesity and cancer. Thirty-one percent of posts contained positive and/or negative sentiment. Facebook was more likely to contain any sentiment, but Twitter contained proportionately more negative sentiment. Concurrent qualitative analysis revealed a dominance of individual blame for overweight/obese persons and more support and empathy for cancer survivors. Our study reflects wide recognition of the evidence linking obesity to increased risk of cancer, a diverse set of factors perceived to be dually associated with both conditions and differing attribution of responsibility. We demonstrate that social media monitoring can provide an important gauge of public health risk perception.
... Second, we assessed the portrayal of e-cigarette videos by investigating the overall attitude to e-cigarettes and documenting promotional and warning content for each video. This study found the vast majority of information on YouTube about e-cigarettes promoted their use and depicted the use of e-cigarettes as socially acceptable, which is agreement with previous studies of tobacco related videos on YouTube [9,[12][13][14][15]17,[19][20][21]. The top 3 most prevalent genres of videos were advertisement videos produced by e-cigarette companies, user sharing videos produced by consumers and product review videos produced by vendors. ...
Background: As the most popular video sharing website in the world, YouTube has the potential to reach and influence a huge audience. This study aims to gain a systematic understanding of what e-cigarette messages people are being exposed to on YouTube by assessing the quantity, portrayal and reach of e-cigarette videos.
Methods: Researchers identified the top 20 search results on YouTube by relevance and view count for the following search terms: “electronic cigarettes”, “e-cigarettes”, “ecigarettes”, “ecigs”, “smoking electronic cigarettes”, “smoking e-cigarettes”, “smoking ecigarettes”, “smoking ecigs”. A sample of 196 unique videos was coded for overall portrayal and genre. Main topics covered in e-cigarette videos were recorded and video statistics and viewer demographic information were documented.
Results: Among the 196 unique videos, 94% (n = 185) were “pro” to e-cigarettes and 4% (n = 8) were neutral, while there were only 2% (n = 3) that were “anti” to e-cigarettes. The top 3 most prevalent genres of videos were advertisement, user sharing and product review. 84.3% of “pro” videos contained Web links for e-cigarette purchase. 71.4% of “pro” videos claimed that e-cigarettes were healthier than conventional cigarettes. Audience was primarily from the United States, the United Kingdom and Canada and “pro” e-cigarette videos were watched more frequently and rated much more favorably than “anti” ones.
Conclusions: The vast majority of information on YouTube about e-cigarettes promoted their use and depicted the use of e-cigarettes as socially acceptable. It is critical to develop appropriate health campaigns to inform e-cigarette consumers of potential harms associated with e-cigarette use.
Background
YouTube has become a popular source of health care information, reaching an estimated 81% of adults in 2021; approximately 35% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data into their research, but guidelines for best practices around research ethics using social media data, such as YouTube, are unclear.
Objective
This study aims to describe approaches to research ethics for public health research implemented using YouTube data.
Methods
We implemented a systematic review of articles found in PubMed, SocINDEX, Web of Science, and PsycINFO following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To be eligible to be included, studies needed to be published in peer-reviewed journals in English between January 1, 2006, and October 31, 2019, and include analyses on publicly available YouTube data on health or public health topics; studies using primary data collection, such as using YouTube for study recruitment, interventions, or dissemination evaluations, were not included. We extracted data on the presence of user identifying information, institutional review board (IRB) review, and informed consent processes, as well as research topic and methodology.
Results
This review includes 119 articles from 88 journals. The most common health and public health topics studied were in the categories of chronic diseases (44/119, 37%), mental health and substance use (26/119, 21.8%), and infectious diseases (20/119, 16.8%). The majority (82/119, 68.9%) of articles made no mention of ethical considerations or stated that the study did not meet the definition of human participant research (16/119, 13.4%). Of those that sought IRB review (15/119, 12.6%), 12 out of 15 (80%) were determined to not meet the definition of human participant research and were therefore exempt from IRB review, and 3 out of 15 (20%) received IRB approval. None of the 3 IRB-approved studies contained identifying information; one was explicitly told not to include identifying information by their ethics committee. Only 1 study sought informed consent from YouTube users. Of 119 articles, 33 (27.7%) contained identifying information about content creators or video commenters, one of which attempted to anonymize direct quotes by not including user information.
Conclusions
Given the variation in practice, concrete guidelines on research ethics for social media research are needed, especially around anonymizing and seeking consent when using identifying information.
Trial Registration
PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=148170
Purpose:
Smokeless tobacco (SLT) use is more common among White male youth in rural locations than among other youth. Previous literature documents risk factors for SLT use (e.g., perceived harm). However, no research has examined whether SLT initiation is associated with the use of social media and video games, despite the high prevalence of those behaviors among adolescent males.
Methods:
As part of the evaluation of "The Real Cost" smokeless prevention campaign, we conducted a baseline survey of a cohort of US males aged 11-16 in 2016 and four follow-up surveys conducted approximately every 8 months. We used discrete-time survival analysis to examine factors associated with SLT initiation. Logistic regression estimated the odds of initiation as a function of lagged values of key predictors (social media use in tertiles and frequency of gaming) and other baseline and lagged correlates. The model controlled for campaign exposure.
Results:
Relative to the lowest tertile of social media use, moderate (odds ratio [OR] = 1.80) or high use (OR = 2.77) was associated with increased risk of SLT initiation at the subsequent survey wave. Relative to playing every few weeks or less, playing video games once a day (OR = 0.50) or several times a day (OR = 0.33) was associated with decreased risk of SLT initiation.
Discussion:
SLT initiation was positively associated with social media use and negatively associated with gaming. Future research should explore reasons for the protective nature of gaming (e.g., social support, improved mood) and whether parental supervision of social media use could mitigate its negative impact.
BACKGROUND
YouTube has become a popular source of healthcare information reaching an estimated 73% of adults in 2019; approximately 35% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data in their research, with varying methodologies for sampling, defining measures, and handling ethical concerns.
OBJECTIVE
To understand the types of public health research being implemented with YouTube data and the methodologies and research ethics processes applied to this research.
METHODS
We implemented a systematic review of articles that were published in peer reviewed journals in English between January 1, 2006 and October 31, 2019 and concerned public health and social media. We extracted data on yearly publication rate, journal impact factor (IF), sampling methods, outcome types, external validity, measures of popularity, presence of user identifying information, IRB review, and informed consent processes.
RESULTS
This review includes 119 articles from 88 journals. The number of articles published per year increased from two in 2007 to 16 in 2016 and 2017 and then declined to approximately 10 in 2019. Median IF of the journals publishing these studies has remained below 5.0 since 2009. The most common public health topics studied were in the categories of chronic diseases other than cancers (n=28, 23.5%), infectious diseases (n=20, 16.8%), and substance use (n=19, 16.0%). Most studies used content analysis to describe the themes of videos (n=89, 74.8%), while the remainder reported on the quality or utility of videos (n=35, 29.4%), and public opinion or attitudes about video topics (n=31, 26.1%). Few articles scored poorly for quality metrics (n=22, 18.5%). The quality metric most lacking was “validity of measures” (only 6 of 75 studies [8.0%] achieved this metric), followed by “sufficiently rigorous statistical analysis” (14 of 119 studies [11.8%] achieved this metric). The majority (n=82, 68.9%) of articles made no mention of ethical considerations in study design or data collection. Thirty-three (27.7%) contained identifying information about content creators or video commenters. About a quarter of studies sought IRB approval (n=31, 26.1%), but only one sought informed consent from content creators.
CONCLUSIONS
We found great interest in using YouTube to answer public health questions as indicated by the quantity of articles and the increase in rate of publication over time. However, more careful consideration of study design and thorough validation of outcome measures will strengthen future studies. Debate about the ethics of social media data usage is ongoing. Concrete guidelines on ethical considerations, especially from IRBs, are needed for social media research.
CLINICALTRIAL
PROSPERO Registration Number CRD42020148170.
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.
Background: Social media can be powerful tools to influence high-risk behaviors. This study aimed to evaluate tobacco-related images on Instagram’s Persian-language pages and their audience attraction rates. Materials and Methods: This cross-sectional study included 1870 Instagram posts with cigar, cigarette, e-cigarette, tobacco, vape, and shisha/waterpipe/hookah hashtags. The number of likes and comments for these posts were recorded, and the image type, the attitude of the audience, and the type of caption were noted as well. Results: In general, 500 images (26.7%) had #cigar/cigarette, while 30 (1.6%), 470 (25.1%), 650 (34.8%), 70 (3.7%), and 150 (8%) images had #e-cigarette, #shisha/#waterpipe/#hookah, # tobacco, #juice, and #vape hashtags, respectively. The most common type of image was product images (52.4%). The audience’s attitude towards the images was mostly positive (93.2%). In addition, the most common caption type was sales (76.5%). There was a significant correlation between the number of likes and comments with image hashtags, audience attitude, and caption type. The highest number of likes and comments belonged to images with shisha/waterpipe/hookah hashtags and a positive audience attitude. The sales caption type had the highest number of likes, while the encouragement caption type had the highest number of comments. Eventually, text image types had the highest number of comments. Conclusion: Given the high promotion of tobacco-related posts on Instagram, policymakers should take the necessary measures to reduce the volume of tobacco advertisements.
This study aims to examine how e-cigarette prices and advertising, key determinants of e-cigarette demand, are associated with the demand for smokeless tobacco (SLT) products in the US. Market-level sales and price data by year (2010–2017), quarter, and type of retail store were compiled from Nielsen retail store scanner database. E-cigarette TV advertising ratings data were compiled from Kantar Media. Four-way (market, year, quarter, store type) fixed-effect models were used to estimate the associations between e-cigarette price and TV advertising and sales of SLT products (chewing loose leaf, moist snuff, and snus). Our results showed that a 1% rise in own price was associated with a reduction in sales by 1.8% for chewing loose leaf, 1.6% for moist snuff, and 2.2% for snus, respectively. In addition, a 1% rise in disposable e-cigarette price was associated with 0.3% and 0.6% increased sales for moist snuff and snus, respectively. The association between e-cigarette TV advertising and SLT product sales was not significant. Our results suggest that disposable e-cigarettes and certain SLT products (moist snuff and snus) are potential substitutes. Policies aiming to regulate e-cigarette use and sales need to consider their potential link with the demand for SLT products.
Objectives
This study examines the relationships between recall of exposure to digital marketing of smokeless tobacco, via the internet and social media, and subsequent initiation of smokeless tobacco use one-year follow-up, among young adult never users of smokeless tobacco in Texas.
Methods
Data were from waves 6 (Spring 2017) and 7 (Spring 2018) of the Marketing and Promotions Across Colleges in Texas Study (Project M-PACT); a longitudinal study of two- and four-year Texas college students. Participants were 2,731 young adult never smokeless tobacco users (ages 20-32) with complete data at both assessment periods. A multi-level, multiple logistic regression model was applied, accounting for school clustering, to examine the relationship between recall of exposure to digital marketing of smokeless tobacco at baseline (wave 6) and smokeless tobacco use initiation at one-year follow-up (wave 7). Analyses controlled for important baseline covariates (socio-demographic factors, other marketing exposure, other tobacco product use).
Results
Overall, 14.6% of never smokeless tobacco users reported exposure to smokeless tobacco marketing via digital media. Exposure to digital marketing of smokeless tobacco at baseline was associated with greater odds of smokeless tobacco use initiation among young adult never users (AOR: 2.14; 95%CI: 1.12 – 4.06) at one-year follow-up.
Conclusions
Findings reveal exposure to smokeless tobacco marketing via digital media was common. Further, there appears to be a strong relationship between this exposure and subsequent smokeless tobacco use among young adult never smokeless tobacco users.
YouTube's propagation of misleading protobacco content to youth has the potential to increase their protobacco beliefs, attitudes, and smoking behavior. We assessed the effects of potential interventions aimed at ameliorating the effect of misleading protobacco videos. An online experiment randomly exposed past and current young tobacco users (N = 716) between the ages of 15 and 19 years to real protobacco, pipe-focused YouTube content that was either shown in its original uncorrected form or edited to include either
Videoplattformen im Internet stellen neue Kanäle der Gesundheitskommunikation dar, die an Bedeutung und Reichweite gewinnen. Video-Kommunikatoren sind dabei Gesundheitsprofis, Medienprofis, vor allem aber Gesundheitslaien, die diverse Krankheiten und Beschwerden, medizinische Behandlungsmethoden sowie gesundheitsbewusste Lebensweisen und Prävention thematisieren. Derartige direkt gesundheitsbezogene sowie indirekt gesundheitsrelevante Online-Videos existieren in großer Fülle und haben teilweise sehr hohe Reichweiten, dabei ist die Inhaltsqualität ausgesprochen heterogen. Dementsprechend kann die Rezeption von Online-Gesundheitsvideos sowohl mit positiven Wirkungen (z. B. Patienten-Empowerment), als auch mit negativen Wirkungen (z. B. Verbreitung von Fehlinformationen) einhergehen. Der Beitrag beschreibt erstmals umfassend die Gesundheitskommunikation mittels Online-Videos als wichtigen neuen Untersuchungsgegenstand für die Kommunikationswissenschaft, referiert anhand der Lasswell-Formel den interdisziplinären Forschungsstand und zeigt Forschungslücken auf.
Videoplattformen im Internet stellen neue Kanäle der Gesundheitskommunikation dar, die an Bedeutung und Reichweite gewinnen. Video-Kommunikatoren sind dabei Gesundheitsprofis, Medienprofis, vor allem aber Gesundheitslaien, die diverse Krankheiten und Beschwerden, medizinische Behandlungsmethoden sowie gesundheitsbewusste Lebensweisen und Prävention thematisieren. Derartige direkt gesundheitsbezogene sowie indirekt gesundheitsrelevante Online-Videos existieren in großer Fülle und haben teilweise sehr hohe Reichweiten, dabei ist die Inhaltsqualität ausgesprochen heterogen. Dementsprechend kann die Rezeption von Online-Gesundheitsvideos sowohl mit positiven Wirkungen (z. B. Patienten-Empowerment), als auch mit negativen Wirkungen (z. B. Verbreitung von Fehlinformationen) einhergehen. Der Beitrag beschreibt erstmals umfassend die Gesundheitskommunikation mittels Online-Videos als wichtigen neuen Untersuchungsgegenstand für die Kommunikationswissenschaft, referiert anhand der Lasswell-Formel den interdisziplinären Forschungsstand und zeigt Forschungslücken auf.
Background:
The video-sharing website, YouTube, has become an important avenue for product marketing, including tobacco products. It may also serve as an important medium for promoting electronic cigarettes, which have rapidly increased in popularity and are heavily marketed online. While a few studies have examined a limited subset of tobacco-related videos on YouTube, none has explored e-cigarette videos' overall presence on the platform.
Objective:
To quantify e-cigarette-related videos on YouTube, assess their content, and characterize levels of engagement with those videos. Understanding promotion and discussion of e-cigarettes on YouTube may help clarify the platform's impact on consumer attitudes and behaviors and inform regulations.
Methods:
Using an automated crawling procedure and keyword rules, e-cigarette-related videos posted on YouTube and their associated metadata were collected between July 1, 2012, and June 30, 2013. Metadata were analyzed to describe posting and viewing time trends, number of views, comments, and ratings. Metadata were content coded for mentions of health, safety, smoking cessation, promotional offers, Web addresses, product types, top-selling brands, or names of celebrity endorsers.
Results:
As of June 30, 2013, approximately 28,000 videos related to e-cigarettes were captured. Videos were posted by approximately 10,000 unique YouTube accounts, viewed more than 100 million times, rated over 380,000 times, and commented on more than 280,000 times. More than 2200 new videos were being uploaded every month by June 2013. The top 1% of most-viewed videos accounted for 44% of total views. Text fields for the majority of videos mentioned websites (70.11%); many referenced health (13.63%), safety (10.12%), smoking cessation (9.22%), or top e-cigarette brands (33.39%). The number of e-cigarette-related YouTube videos was projected to exceed 65,000 by the end of 2014, with approximately 190 million views.
Conclusions:
YouTube is a major information-sharing platform for electronic cigarettes. YouTube appears to be used unevenly for promotional purposes by e-cigarette brands, and our analyses indicated a high level of user engagement with a small subset of content. There is evidence that YouTube videos promote e-cigarettes as cigarette smoking cessation tools. Presence and reach of e-cigarette videos on YouTube warrants attention from public health professionals and policymakers.
Each physician, organization, hospital or antismoking center involved in either medical or social antismoking activities should use social media to amplify the impact of their services. At the individual level, these media tools may turn useful to customize intervention and to intensify smokers' follow-up during their quit programs. At the collective level, antismoking media campaigns should be an integral part of an articulated smoking-cessation program in order to educate people about the risks of smoking, create social awareness about behaviors associated with smoking, as well as to change smokers' attitudes towards tobacco and ultimately to reduce smoking prevalence [23]. Studies aimed to identify the most innovative and efficient strategies for combining communication and smoking cessation activities are eagerly awaited.
Waterpipe tobacco is among the most rapidly growing trends in tobacco smoking, the growing use and acceptance of which are taking place at a time when cigarette smoking is regarded in an increasingly negative manner (Martinasek, McDermott, & Martini, 2011). Given the health risks and the misperceptions associated with waterpipe smoking, this study focuses on how waterpipe smoking is portrayed and represented on the social media platform Pinterest. In total, 800 Pinterest pins were content analyzed. The vast majority of the sampled pins were primarily image based. More than half of the pins linked to a website external to Pinterest that often redirected the pinner to a commercial website. Waterpipe-focused pins portrayed waterpipe smoking more in a positive light than in a negative light, and conveyed a sense of pleasure, aesthetic, and relaxation, which tended to trigger more repins, likes, and higher levels of engagement. Overall, the risks of waterpipe smoking were not represented on Pinterest, indicating that the social media portrayal of waterpipe smoking needs improvement and could benefit from a public health perspective.
Objective: To assess the depiction of e-cigarettes in YouTube videos. Methods: The sample (N = 63) was selected from the top 20 search results for “electronic cigarette,” and “e-cig” with each term searched twice by the filters “Relevance” and “View Count.” Data collected included title, length, number of views, “likes,” “dislikes,” comments, and inferred demographics of individuals appearing in the videos. Results: Seventy-six percent of videos included at least one man, 62% included a Caucasian, and 50% included at least one young individual. Video content connotation was coded as positive (76%), neutral (18%), or negative (6%). Videos were categorized as advertisement (33%), instructional (17%), news clip (19%), product review (13%), entertainment (11%), public health (3%), and personal testimonial (3%). Conclusion: Most e-cigarette YouTube videos are non-traditional or covert advertisements featuring young Caucasian men.
Background: The aims of this paper are to describe 1. systematic reviews describing the relation between social media and health and 2. previous research on utilising social media for predicting health on a population level. Method: A literature search utilising PubMed was performed in March 2014.
The inclusion criteria were that the article describes 1. the relation between social media and health or 2. the utilisation of social media in predicting health on a population level. Results: 11 systematic reviews and 4 articles were included in this review. The included articles were published between 2009–2014. There is a lack of knowledge about the relation and outcomes of social media and health. No systematic review on utilising social media to predict health on a population level was identified. Conclusions: Social media may carry crucial yet undiscovered means to predict and interfere in the health of populations. Future research, innovation and development in this area are highly recommended.
Few studies have examined the patterns and correlates of polytobacco use among a large, nationally representative population over an extended period of time.
This study examined 10years of data from the National Survey on Drug Use and Health (NSDUH) to establish time trends and correlates for exclusive and mixed use of cigarettes, smokeless tobacco (SLT), cigars, and pipes.
Results show that rates of polytobacco use were essentially unchanged from 2002 to 2011 (8.7% to 7.4%), though some product combinations, including cigarettes and SLT, cigars and SLT, and use of more than two products have increased. In tobacco users under age 26, the proportion of polytobacco use increased, even as overall tobacco use declined. The factors associated with polytobacco use among tobacco users included sex, income, education, risk taking/seeking behaviors, and outward indicators of 'risk-liability'.
Findings provide a snapshot of trends of single and polytobacco product use as well as trends in combinations of product use. Longitudinal studies are needed to examine the sequence of individual patterns of tobacco product use and to identify whether polytobacco use results in greater nicotine dependence, increased exposure to harmful and potentially harmful constituents and/or greater risk of tobacco related disease.
The Web and especially major Web search engines are essential tools in the quest to locate online information for many people. This paper reports results from research that examines characteristics and changes in Web searching from nine studies of five Web search engines based in the US and Europe. We compare interactions occurring between users and Web search engines from the perspectives of session length, query length, query complexity, and content viewed among the Web search engines. The results of our research shows (1) users are viewing fewer result pages, (2) searchers on US-based Web search engines use more query operators than searchers on European-based search engines, (3) there are statistically significant differences in the use of Boolean operators and result pages viewed, and (4) one cannot necessary apply results from studies of one particular Web search engine to another Web search engine. The wide spread use of Web search engines, employment of simple queries, and decreased viewing of result pages may have resulted from algorithmic enhancements by Web search engine companies. We discuss the implications of the findings for the development of Web search engines and design of online content.
Smoking imagery on the online video sharing site YouTube is prolific and easily accessed. However, no studies have examined how this content changes across time. We studied the primary message and genre of YouTube videos about smoking across two time periods.
In May and July 2009, we used "cigarettes" and "smoking cigarettes" to retrieve the top 20 videos on YouTube by relevance and view count. Eliminating duplicates, 124 videos were coded for time period, overall message, genre, and brand mentions. Data were analyzed using descriptive statistics.
Videos portraying smoking positively far outnumbered smoking-negative videos in both samples, increasing as a percentage of total views across the time period. Fifty-eight percent of videos in the second sample were new. Among smoking-positive videos, music and magic tricks were most numerous, increasing from 66% to nearly 80% in July, with music accounting for most of the increase. Marlboro was the most frequently mentioned brand.
Videos portraying smoking positively predominate on YouTube, and this pattern persists across time. Tobacco control advocates could use YouTube more effectively to counterbalance prosmoking messages.
The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) bans all forms of tobacco advertising, promotion and sponsorship. The comprehensiveness of this ban has yet to be tested by online social networking media such as Facebook. In this paper, the activities of employees of the transnational tobacco company, British American Tobacco, (BAT) on Facebook and the type of content associated with two globally popular BAT brands (Dunhill and Lucky Strike) are mapped.
BAT employees on Facebook were identified and then the term 'British American Tobacco' was searched for in the Facebook search engine and results recorded, including titles, descriptions, names and the number of Facebook participants involved for each search result. To further detail any potential promotional activities, a search for two of BAT's global brands, 'Dunhill' and 'Lucky Strike', was conducted.
Each of the 3 search terms generated more than 500 items across a variety of Facebook subsections.
Some BAT employees are energetically promoting BAT and BAT brands on Facebook through joining and administrating groups, joining pages as fans and posting photographs of BAT events, products and promotional items. BAT employees undertaking these actions are from countries that have ratified the WHO FCTC, which requires signatories to ban all forms of tobacco advertising, including online and crossborder exposure from countries that are not enforcing advertising restrictions. The results of the present research could be used to test the comprehensiveness of the advertising ban by requesting that governments mandate the removal of this promotional material from Facebook.
This study examined the prevalence, accessibility, and characteristics of eroticized smoking portrayal, also referred to as smoking fetish, on YouTube. The analysis of 200 smoking fetish videos revealed that the smoking fetish videos are prevalent and accessible to adolescents on the website. They featured explicit smoking behavior by sexy, young, and healthy females, with the content corresponding to PG-13 and R movie ratings. We discuss a potential impact of the prosmoking image on youth according to social cognitive theory, and implications for tobacco control.
We performed a content analysis of all Web pages viewed by a random sample of adolescents to describe exposure to tobacco- and smoking-related text and images.
Adolescents (14-17 years of age) with home Internet access were recruited. Internet-tracking software was installed on home computers used by 346 eligible consenting participants. All Web pages viewed by adolescent participants were captured during a 30-day period for each subject. Keywords on smoking and tobacco were used to identify tobacco images or text.
The 346 participants viewed 1.2 million Web pages, of which 8702 (0.72%) contained tobacco or smoking content. Exposure to tobacco content did not vary according to smoking status. Content was protobacco on 1916 pages, antitobacco on 1572, and complex or unclear on 5055. Social networking sites, mainly MySpace, represented 53% of pages (n = 4612) on which tobacco content was found. All pages with smoking content contained references in text, and 256 (3%) contained images. Many (43%) of the adolescents were exposed to protobacco imagery (median: 3 pages per month). Cigarettes were mentioned on 20% of pages. Tobacco products were sold on 50 pages, and 242 pages contained links to tobacco products sold on other pages. On social networking sites, 4121 pages included a mention of smoking status in the authors' individual profiles, with 23% of authors identifying themselves as smokers.
Many adolescents are consistently exposed to tobacco content on the Internet, but the volume of exposure is limited and not all content represents protobacco content.
On March 25, 1986, the Surgeon General of the Public Health Service released a report that detailed the results of the first comprehensive, indepth review of the relationship between smokeless tobacco use and health. This review, prepared under the auspices of the Surgeon General's Advisory Committee on the Health Consequences of Using Smokeless Tobacco, is summarized in this article. In the United States, smokeless tobacco is used predominantly in the forms of chewing tobacco and snuff. During the past 20 years, the production and consumption of these products have risen significantly in marked contrast to the decline in smokeless tobacco use during the first half of the century. National estimates indicate that more than 12 million persons age 12 and older in the United States used some form of smokeless tobacco in 1985, and half of these were regular users. The highest rates of smokeless tobacco use occurred among adolescent and young adult males. Examination of the relevant epidemiologic, experimental, and clinical data revealed that oral use of smokeless tobacco is a significant health risk. This behavior can cause cancer in humans, and the evidence is strongest for cancer of the oral cavity, particularly at the site of tobacco placement. Smokeless tobacco use can also lead to the development of noncancerous oral conditions, particularly, oral leukoplakias and gingival recession. Further, the levels of nicotine in the body resulting from smokeless tobacco can lead to nicotine addiction and dependence.
This year's surgeon general's report on smoking and health is the first such report to focus on young people. From extensive data that indicate that tobacco use is a pediatric epidemic, the report reached six major conclusions: (1) Nearly all first use of tobacco occurs by age 18. (2) Most adolescent smokers are addicted to nicotine. (3) Tobacco is often the first drug used by young people who subsequently use illegal drugs. (4) There are identified psychosocial risk factors for the onset of tobacco use. (5) Cigarette advertising also appears to increase young people's risk of smoking. (6) Communitywide efforts have successfully reduced adolescent use of tobacco. This commentary restates each of the six conclusions, summarizes the data that support each, and then considers the implications of the conclusions for public health action.
Smokeless tobacco use in the United States has increased over the last two decades largely due to increased consumption by young people. Rates of use are highest among teenage and young adult males, and the most popular form of smokeless tobacco is moist snuff. Peer pressure as well as use of other addictive substances such as cigarettes, drugs, and alcohol, seem to correlate with current use. Frequent users of smokeless tobacco have an increased risk of developing gingival recession, leukoplakia, and oral cancer at the placement site. Other health concerns are related to the cardiovascular effects and addictive nature of nicotine. Because the smokeless tobacco habit is difficult to break, public health efforts have been largely aimed at prevention. The dental professional also can play an important role in recognizing the smokeless tobacco user and facilitating cessation.
The purpose of this study was to provide estimates of the cumulative incidence of initiation of smokeless tobacco use in a cohort of young persons and to explore sociodemographic, environmental, behavioral, and personal predictors of experimentation with and regular use of snuff or chewing tobacco.
The data for this cohort study were derived from the 1989 Teenage Attitudes and Practices Survey and its 1993 follow-up. The study included 7830 young people 11 through 19 years of age at baseline.
During the 4 years, 12.7% of participants (20.9% of male participants) first tried smokeless tobacco, and 4.0% (8.0% of male participants) became self-classified regular users. This suggests that, each year, approximately 824000 young people in the United States 11 to 19 years of age experiment with smokeless tobacco and about 304 000 become regular users. Cumulative incidence was highest for male non-Hispanic Whites. Predictors of regular use included age, geographic region, cigarette smoking, participation in organized sports, and perceived friends' approval or indifference.
Public health approaches to preventing use of smokeless tobacco should include development of skills for responding to pressures to use tobacco.
In a press release dated April 6, 2009, Swedish Match North America announced the launch of a new website promoting its General Snus brand.1 Included with this release was a link to a professionally made video hosted on the YouTube website. Entitled ‘General Snus Is The Less Harmful Alternative. Do You SNUS,’ the video described General Snus flavours, features of the new website and directed viewers to the website with an offer of free samples.2 …
The internet is an ideal forum for tobacco marketing, as it is largely unregulated and there is no global governing body for controlling content. Nevertheless, tobacco companies deny advertising on the internet.
To assess the extent and nature of English language videos available on the Web 2.0 domain 'YouTube' that contain tobacco brand images or words.
The authors conducted a YouTube search using five leading non-Chinese cigarette brands worldwide. The themes and content of up to 40 of the most viewed videos returned for each search were analysed: a total of 163 videos.
A majority of the 163 tobacco brand-related videos analysed (71.2%, 95% CI 63.9 to 77.7) had pro-tobacco content, versus a small minority (3.7%) having anti-tobacco content (95% CI 1.4 to 7.8). Most of these videos contained tobacco brand content (70.6%), the brand name in the title (71.2%) or smoking imagery content (50.9%). One pro-smoking music video had been viewed over 2 million times. The four most prominent themes of the videos were celebrity/movies, sports, music and 'archive', the first three of which represent themes of interest to a youth audience.
Pro-tobacco videos have a significant presence on YouTube, consistent with indirect marketing activity by tobacco companies or their proxies. Since content may be removed from YouTube if it is found to breach copyright or if it contains offensive material, there is scope for the public and health organisations to request the removal of pro-tobacco content containing copyright or offensive material. Governments should also consider implementing Framework Convention on Tobacco Control requirements on the internet, to further reduce such pro-tobacco content.
From 2000 to 2006, moist snuff sales have increased and now account for 71% of the smokeless tobacco market. Previous research has shown that major manufacturers of smokeless tobacco products manipulated free nicotine, the form most readily absorbed, to promote tolerance and addiction.
This study examines the possibility that company-specific and brand-specific strategies of the major moist snuff manufacturers involve controlling free nicotine content and ease of dosing with products that are designed and targeted to specific groups. This study looks at the current total US moist snuff market with product design data from the Massachusetts Department of Public Health; moist snuff use from the National Survey on Drug Use and Health; market data from ACNielsen; and magazine advertising expenditures from TNS Media Intelligence.
(1) The levels of free nicotine of moist snuff products have increased over time for several major manufacturers; (2) the number and variety of sub-brands have increased over time; (3) changes in design, as reflected by variation in free nicotine associated with pH or tobacco leaf, or both, have enhanced the ease and uniformity of dosing; (4) marketing through price and advertising has increased; and (5) youth use has increased.
A combination of factors including brand proliferation, control of free nicotine and product design has most likely resulted in the expanded consumption of moist snuff, particularly among young people.
With advertising bans eroding direct tobacco advertising and promotional opportunities, tobacco companies are embracing more covert means of keeping their products in the minds of current and potential consumers. Compared with the breadth of published research on “above-the-line” tobacco advertising, research examining “below-the-line”1 indirect forms of tobacco promotion is in its infancy. Promotions at dance parties,2 themed nights in hip clubs,3 bars and music festivals,4 and disguising market research as sampling promotions5 are examples of identified strategies. Just as tobacco company marketers have infiltrated youth-friendly venues, it is conceivable that they also have a presence on youth-friendly websites. While the world wide web (WWW) is being used extensively to sell cigarettes,6 its largely unregulated status holds much potential as a vehicle for both promoting smoking and particular brands of tobacco products, and for promoting antismoking discourse.
The WWW is no longer a vehicle to simply retrieve information and purchase goods, it is now a fully interactive and participatory platform.7 Coined in 2004 as Web 2.0, the WWW is increasingly being driven by consumer-generated content.8 It is both timely and critical to examine tobacco marketing in the Web 2.0 era. We are particularly interested in websites that appeal to youth and young adults, the same target population for tobacco companies. Internet use by young people is part of their everyday life; in 2006, more than half of youth and young adult Australians (aged 15–24 years) used the internet on a daily basis.9 The website YouTube (www.youtube.com) is an ideal example of a youth-friendly website that embodies the Web 2.0 principles of participation. It has the potential to be a fruitful place for tobacco marketers to turn their efforts.
### What is YouTube?
YouTube was founded in February 2005, as a “consumer media company for people to …
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