ABSTRACT
To combat the e-cigarette epidemic among young audiences, a federal law was passed in the US that raised the minimum legal sales age of tobacco to 21 years (commonly known as Tobacco 21). Little is known about sentiment toward this law. Thus, the purpose of our study was to systematically explore trends about Tobacco 21 discussions and comparisons to other age-restriction behaviors on Twitter. Twitter data (n = 4628) were collected from September to December of 2019 that were related to Tobacco 21. A random subsample of identified tweets was used to develop a codebook. Two trained coders independently coded all data, with strong inter-rater reliability (κ = 0.71 to 0.93) found for all content categories. Associations between sentiment and content categories were calculated using χ2 analyses. Among relevant tweets (n = 955), the most common themethe disjunction between ages for military enlistment and tobacco usewas found in 17.8% of all tweets. Anti-policy sentiment was strongly associated with the age of military enlistment, alcohol, voting, and adulthood (p < 0.001 for all). Opposition to Tobacco 21 propagates on social media because the US federal law does not exempt military members. However, the e-cigarette epidemic may have fueled some support for this law.
Subject(s)
Electronic Nicotine Delivery Systems , Social Media , Adult , Humans , Policy , Reproducibility of Results , NicotianaABSTRACT
INTRODUCTION: Alcohol and tobacco are commonly used together. Social influences within online social networking platforms contribute to youth and young adult substance use behaviors. This study used a sample of alcohol- and tobacco-related tweets to evaluate: (1) sentiment toward co-use of alcohol and tobacco, (2) increased susceptibility to tobacco use when consuming alcohol, and (3) the role of alcohol in contributing to a failed attempt to quit tobacco use. METHODS: Data were collected from the Twitter API from January 1, 2019 through December 31, 2019 using tobacco-related keywords (e.g., vape, ecig, smoking, juul*) and alcohol-related filters (e.g., drunk, blackout*). A total of 78,235 tweets were collected, from which a random subsample (n = 1,564) was drawn for coding. Cohen's Kappa values ranged from 0.66 to 0.99. RESULTS: Most tweets were pro co-use of alcohol and tobacco (75%). One of every ten tweets reported increased susceptibility to tobacco use when intoxicated. Non-regular tobacco users reported cravings for and tobacco use when consuming alcohol despite disliking tobacco use factors such as the taste, smell, and/or negative health effects. Regular tobacco users reported using markedly higher quantities of tobacco when intoxicated. Individuals discussed the role of alcohol undermining tobacco cessation attempts less often (2.0%), though some who had quit smoking for prolonged periods of time reported reinitiating tobacco use during acute intoxication episodes. CONCLUSIONS: Tobacco cessation interventions may benefit from including alcohol-focused components designed to educate participants about the association between increased susceptibility to tobacco use when consuming alcohol and the role of alcohol in undermining tobacco cessation attempts. IMPLICATIONS: Sentiment toward co-use of alcohol and tobacco on Twitter is largely positive. Individuals reported regret about using tobacco, or using more than intended, when intoxicated. Those who had quit smoking or vaping for prolonged periods of time reported reinitiating tobacco use when consuming alcohol. While social media-based tobacco cessation interventions like the Truth Initiative's "Ditch the Juul" campaign demonstrate potential to change tobacco use behaviors, these campaigns may benefit from including alcohol-focused components designed to educate participants about the association between increased susceptibility to tobacco use when consuming alcohol and the role of alcohol in undermining tobacco cessation attempts.
