Analysis of potential associations of JUUL flavours with health symptoms based on user-generated data from Reddit.

BACKGROUND: The rise of the popular e-cigarette, JUUL, has been partly attributed to various teen-friendly e-liquid flavours offered. However, the possible health risks associated with each e-liquid flavour still remain unclear. This research focuses on the possible associations between JUUL flavours and health symptoms using social media data from Reddit. METHODS: Keyword filtering was used to obtain 5,746 JUUL flavour-related posts and 7927 health symptom-related posts from June 2015 to April 2019 from Reddit. Posts from September 2016 to April 2019 were used to conduct temporal analysis for nine health symptom categories and the 8 JUUL flavours. Finally, associations between the JUUL flavours and health symptom categories were examined on the user level using generalised estimating equation models. RESULTS: According to our temporal analysis, Mango and Mint were the most discussed JUUL flavours on Reddit. Respiratory and throat symptoms were the most discussed health issues together with JUUL on Reddit over time. Respiratory symptoms had potential associations with the Mango, Mint and Fruit JUUL flavours. Digestive symptoms had a potential association with the Crème flavour, psychological symptoms had a potential association with the Cucumber flavour, and cardiovascular symptoms had a potential association with the tobacco flavours. CONCLUSIONS: Mango and Mint were the two most mentioned JUUL flavours on Reddit. Certain JUUL flavours were more likely to be mentioned together with certain categories of health symptoms by the same Reddit users. Our findings could prompt further medical research into the health symptoms associated with different e-liquid flavours.

A Social Media Study on the Associations of Flavored Electronic Cigarettes With Health Symptoms: Observational Study.

BACKGROUND: In recent years, flavored electronic cigarettes (e-cigarettes) have become popular among teenagers and young adults. Discussions about e-cigarettes and e-cigarette use (vaping) experiences are prevalent online, making social media an ideal resource for understanding the health risks associated with e-cigarette flavors from the users' perspective. OBJECTIVE: This study aimed to investigate the potential associations between electronic cigarette liquid (e-liquid) flavors and the reporting of health symptoms using social media data. METHODS: A dataset consisting of 2.8 million e-cigarette-related posts was collected using keyword filtering from Reddit, a social media platform, from January 2013 to April 2019. Temporal analysis for nine major health symptom categories was used to understand the trend of public concerns related to e-cigarettes. Sentiment analysis was conducted to obtain the proportions of positive and negative sentiment scores for all reported health symptom categories. Topic modeling was applied to reveal the topics related to e-cigarettes and health symptoms. Furthermore, generalized estimating equation (GEE) models were used to quantitatively measure potential associations between e-liquid flavors and the reporting of health symptoms. RESULTS: Temporal analysis showed that the Respiratory category was consistently the most discussed health symptom category among all categories related to e-cigarettes on Reddit, followed by the Throat category. Sentiment analysis showed higher proportions of positive sentiment scores for all reported health symptom categories, except for the Cancer category. Topic modeling conducted on all health-related posts showed that 17 of the top 100 topics were flavor related. GEE models showed different associations between the reporting of health symptoms and e-liquid flavor categories, for example, lower association of the Beverage flavors with Respiratory compared with other flavors and higher association of the Fruit flavors with Cardiovascular than other flavors. CONCLUSIONS: This study identified different potential associations between e-liquid flavors and the reporting of health symptoms using social media data. The results of this study provide valuable information for further investigation of the health effects associated with different e-liquid flavors.

User Perceptions of Different Electronic Cigarette Flavors on Social Media: Observational Study.

BACKGROUND: The number of electronic cigarette (e-cigarette) users has been increasing rapidly in recent years, especially among youth and young adults. More e-cigarette products have become available, including e-liquids with various brands and flavors. Various e-liquid flavors have been frequently discussed by e-cigarette users on social media. OBJECTIVE: This study aimed to examine the longitudinal prevalence of mentions of electronic cigarette liquid (e-liquid) flavors and user perceptions on social media. METHODS: We applied a data-driven approach to analyze the trends and macro-level user sentiments of different e-cigarette flavors on social media. With data collected from web-based stores, e-liquid flavors were classified into categories in a flavor hierarchy based on their ingredients. The e-cigarette-related posts were collected from social media platforms, including Reddit and Twitter, using e-cigarette-related keywords. The temporal trend of mentions of e-liquid flavor categories was compiled using Reddit data from January 2013 to April 2019. Twitter data were analyzed using a sentiment analysis from May to August 2019 to explore the opinions of e-cigarette users toward each flavor category. RESULTS: More than 1000 e-liquid flavors were classified into 7 major flavor categories. The fruit and sweets categories were the 2 most frequently discussed e-liquid flavors on Reddit, contributing to approximately 58% and 15%, respectively, of all flavor-related posts. We showed that mentions of the fruit flavor category had a steady overall upward trend compared with other flavor categories that did not show much change over time. Results from the sentiment analysis demonstrated that most e-liquid flavor categories had significant positive sentiments, except for the beverage and tobacco categories. CONCLUSIONS: The most updated information about the popular e-liquid flavors mentioned on social media was investigated, which showed that the prevalence of mentions of e-liquid flavors and user perceptions on social media were different. Fruit was the most frequently discussed flavor category on social media. Our study provides valuable information for future regulation of flavored e-cigarettes.