Public Perceptions and Discussions of the US Food and Drug Administration's JUUL Ban Policy on Twitter: Observational Study.

BACKGROUND: On June 23, 2022, the US Food and Drug Administration announced a JUUL ban policy, to ban all vaping and electronic cigarette products sold by Juul Labs. OBJECTIVE: This study aims to understand public perceptions and discussions of this policy using Twitter (subsequently rebranded as X) data. METHODS: Using the Twitter streaming application programming interface, 17,007 tweets potentially related to the JUUL ban policy were collected between June 22, 2022, and July 25, 2022. Based on 2600 hand-coded tweets, a deep learning model (RoBERTa) was trained to classify all tweets into propolicy, antipolicy, neutral, and irrelevant categories. A deep learning model (M3 model) was used to estimate basic demographics (such as age and gender) of Twitter users. Furthermore, major topics were identified using latent Dirichlet allocation modeling. A logistic regression model was used to examine the association of different Twitter users with their attitudes toward the policy. RESULTS: Among 10,480 tweets related to the JUUL ban policy, there were similar proportions of propolicy and antipolicy tweets (n=2777, 26.5% vs n=2666, 25.44%). Major propolicy topics included "JUUL causes youth addition," "market surge of JUUL," and "health effects of JUUL." In contrast, major antipolicy topics included "cigarette should be banned instead of JUUL," "against the irrational policy," and "emotional catharsis." Twitter users older than 29 years were more likely to be propolicy (have a positive attitude toward the JUUL ban policy) than those younger than 29 years. CONCLUSIONS: Our study showed that the public showed different responses to the JUUL ban policy, which varies depending on the demographic characteristics of Twitter users. Our findings could provide valuable information to the Food and Drug Administration for future electronic cigarette and other tobacco product regulations.

Characterizing Anti-Vaping Posts for Effective Communication on Instagram Using Multimodal Deep Learning.

INTRODUCTION: Instagram is a popular social networking platform for sharing photos with a large proportion of youth and young adult users. We aim to identify key features in anti-vaping Instagram image posts associated with high social media user engagement by artificial intelligence. AIMS AND METHODS: We collected 8972 anti-vaping Instagram image posts and hand-coded 2200 Instagram images to identify nine image features such as warning signs and person-shown vaping. We utilized a deep-learning model, the OpenAI: contrastive language-image pre-training with ViT-B/32 as the backbone and a 5-fold cross-validation model evaluation, to extract similar features from the Instagram image and further trained logistic regression models for multilabel classification. Latent Dirichlet Allocation model and Valence Aware Dictionary and sEntiment Reasoner were used to extract the topics and sentiment from the captions. Negative binomial regression models were applied to identify features associated with the likes and comments count of posts. RESULTS: Several features identified in anti-vaping Instagram image posts were significantly associated with high social media user engagement (likes or comments), such as educational warnings and warning signs. Instagram posts with captions about health risks associated with vaping received significantly more likes or comments than those about help quitting smoking or vaping. Compared to the model based on 2200 hand-coded Instagram image posts, more significant features have been identified from 8972 AI-labeled Instagram image posts. CONCLUSION: Features identified from anti-vaping Instagram image posts will provide a potentially effective way to communicate with the public about the health effects of e-cigarette use. IMPLICATIONS: Considering the increasing popularity of social media and the current vaping epidemic, especially among youth and young adults, it becomes necessary to understand e-cigarette-related content on social media. Although pro-vaping messages dominate social media, anti-vaping messages are limited and often have low user engagement. Using advanced deep-learning and statistical models, we identified several features in anti-vaping Instagram image posts significantly associated with high user engagement. Our findings provide a potential approach to effectively communicate with the public about the health risks of vaping to protect public health.

Public Perceptions on the Policy of Electronic Cigarettes as Medical Products on Twitter.

Starting from 1 October 2021, Australia requires a prescription for purchasing nicotine vaping products. On 29 October 2021, the UK provided a guideline to treat e-cigarettes as medical products. This study aims to understand public perceptions of the prescription policy in Australia and the UK on Twitter. Tweets related to e-cigarettes from 20 September 2021 to 31 December 2021 were collected through Twitter streaming API. We adopted both a human and machine learning model to identify a total of 1795 tweets from the UK and Australia related to the prescription policy. We classified them into pro-policy, anti-policy, and neutral-to-policy groups, and further characterized tweets into different topics. Compared to Australia, the proportion of pro-policy tweets in the UK was significantly higher (19.43% vs. 10.92%, p < 0.001), while the proportion of anti-policy tweets was significantly lower (43.4% vs. 50.09%, p = 0.003). The main topics for different attitudes towards the prescription policy between the two countries showed some significant differences, for example, "help quit smoking" in the UK and "health effect of e-cigarettes" in Australia for the positive attitude, "economic effect" in the UK and "preventing smoking cessation" in Australia for the negative attitude, which reflected different public concerns. The findings might provide valuable guidance for other countries to implement a similar policy in the future.