A Toxic Blend: Assessing the Effects of Cross-Source Media Coverage of Flavored E-Cigarettes on Youth and Young Adult Perceptions

Abstract

Flavored e-cigarettes have received high attention across social and news media. How does exposure to e-cigarette flavors across multiple sources in the media environment influence youth e-cigarette perceptions? To address this question, we identified e-cigarette flavor mentions on 24.3 million Twitter posts and 11,691 longform texts (newspapers, broadcast news, and websites) disseminated over 3 years (2014–2017). During the same period, we measured e-cigarette beliefs through a nationally representative randomly sampled rolling survey of 13–26-year-olds (N = 4,470, 1013 days). We estimated the association between flavor-specific content on Twitter and longform sources in the 28 days prior to each survey date and perceptions that e-cigarettes taste good.

The interaction of coverage on Twitter and longform sources was significantly associated with more favorable perceptions of e-cigarette taste (OR = 1.21; 95% CI, 1.04–1.41); the main effects of each source type were not significant. This study presents a novel approach to evaluating the effects of cross-source coverage in today’s complex media landscape and may strengthen claims for media influence on e-cigarette use.

Acknowledgments

Research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and FDA Center for Tobacco Products (CTP) under Award Number P50CA179546. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration (FDA). The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Special thank you to Laura Gibson, Emma Jesch, Leeann Sieal, Kwanho Kim, Chiomo Woko, Allyson Volinsky, Emily Falk, and Matthew O’Donnell, for their feedback and support on this project. The authors have no conflicts of interest.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

¹ Electronic cigarettes are devices that heat liquids (“e-juice” or “vape juice”) to produce inhalable aerosols. Many e-juices contain nicotine, tetrahydrocannobinol (THC), and/or flavoring additives. Electronic cigarettes are also called e-cigarettes, e-cigs, vapes, vape pens, and electronic nicotine delivery systems (ENDS) (National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services, 2020).

² On January 2, 2020, the U.S. Food and Drug Administration (FDA) issued a guidance banning the sale of certain types of flavored e-cigarettes (Food & Administration, 2020). Despite the highly publicized discussions around this decision, the final regulation includes several loopholes, leaving many flavored e-cigarettes on the market (Hemmerich, 2020).

³ We refer to this latter category of sources as “longform” due to the length of each text relative to Twitter posts (limited to 140 characters during most of the period studied).

⁴ LIWC’s category “perceptual processes” includes 273 terms associated with the five senses and “ingestion” includes 111 terms related to eating (Pennebaker, Boyd, Jordan, & Blackburn, 2015). Of the flavor-relevant terms added to the Sample 1-generated script, 90% were categorized by LIWC into one or both of these two categories.

Additional information

Funding

This work was supported by the National Cancer Institute [P50CA179546].