Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content

DOI

10.2196/26335

Authors

Jaime E. Sidani, University of Pittsburgh Graduate School of Public Health
Beth Hoffman, University of Pittsburgh Graduate School of Public Health
Jason B. Colditz, University of Pittsburgh School of Medicine
Riley Wolynn, University of Pittsburgh
Lily Hsiao, University of Pittsburgh
Kar Hai Chu, University of Pittsburgh Graduate School of Public Health
Jason J. Rose, University of Pittsburgh School of Medicine
Ariel Shensa, Duquesne University
Esa Davis, University of Pittsburgh School of Medicine
Brian Primack, University of Arkansas

Document Type

Journal Article

Publication Date

4-1-2022

Publication Title

JMIR Formative Research

Volume

6

Issue

4

Keywords

communication, concern, conspiracy, coronavirus, COVID-19, discussion, e-cigarette, electronic nicotine delivery systems, misinformation, public health, severity, social media, Twitter

Abstract

Background: Misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS) are increasing. Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the e-cigarette or vaping product use-associated lung injury (EVALI) outbreak of 2019 was actually an early presentation of COVID-19. This may have important public health ramifications for both COVID-19 control and ENDS use. Objective: Twitter is an ideal tool for analyzing real-time public discussions related to both ENDS and COVID-19. This study seeks to collect and classify Twitter messages ("tweets") related to ENDS and COVID-19 to inform public health messaging. Methods: Approximately 2.1 million tweets matching ENDS-related keywords were collected from March 1, 2020, through June 30, 2020, and were then filtered for COVID-19-related keywords, resulting in 67,321 original tweets. A 5% (n=3366) subsample was obtained for human coding using a systematically developed codebook. Tweets were coded for relevance to the topic and four overarching categories. Results: A total of 1930 (57.3%) tweets were coded as relevant to the research topic. Half (n=1008, 52.2%) of these discussed a perceived association between ENDS use and COVID-19 susceptibility or severity, with 42.4% (n=818) suggesting that ENDS use is associated with worse COVID-19 symptoms. One-quarter (n=479, 24.8%) of tweets discussed the perceived similarity/dissimilarity of COVID-19 and EVALI, and 13.8% (n=266) discussed ENDS use behavior. Misinformation and conspiracy theories were present throughout all coding categories. Conclusions: Discussions about ENDS use and COVID-19 on Twitter frequently highlight concerns about the susceptibility and severity of COVID-19 for ENDS users; however, many contain misinformation and conspiracy theories. Public health messaging should capitalize on these concerns and amplify accurate Twitter messaging.

Open Access

Gold

Repository Citation

Sidani, J., Hoffman, B., Colditz, J., Wolynn, R., Hsiao, L., Chu, K., Rose, J., Shensa, A., Davis, E., & Primack, B. (2022). Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content. JMIR Formative Research, 6 (4). https://doi.org/10.2196/26335