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BackgroundThe sale of electronic cigarettes (e-cigarettes) containing nicotine is prohibited in all Australian states and territories; yet, the growing availability and convenience of the internet enable the promotion and exposure of e-cigarettes across countries. Social media’s increasing pervasiveness has provided a powerful avenue to market products and influence social norms and risk behaviors. At present, there is no evidence of how e-cigarettes and vaping are promoted on social media in Australia. ObjectiveThis study aimed to investigate how e-cigarettes are portrayed and promoted on Twitter through a content analysis of vaping-related tweets containing an image posted and retweeted by Australian users and how the portrayal and promotion have emerged and trended over time. MethodsIn total, we analyzed 1303 tweets and accompanying images from 2012, 2014, 2016, and 2018 collected through the Tracking Infrastructure for Social Media Analysis (TrISMA), a contemporary technical and organizational infrastructure for the tracking of public communication by Australian users of social media, via a list of 15 popular e-cigarette–related terms. ResultsDespite Australia’s cautious approach toward e-cigarettes and the limited evidence supporting them as an efficacious smoking cessation aid, it is evident that there is a concerted effort by some Twitter users to promote these devices as a health-conducive (91/129, 70.5%), smoking cessation product (266/1303, 20.41%). Further, Twitter is being used in an attempt to circumvent Australian regulation and advocate for a more liberal approach to personal vaporizers (90/1303, 6.90%). A sizeable proportion of posts was dedicated to selling or promoting vape products (347/1303, 26.63%), and 19.95% (260/1303) were found to be business listings. These posts used methods to try and expand their clientele further than immediate followers by touting competitions and giveaways, with those wanting to enter having to perform a sequence of steps such as liking, tagging, and reposting, ultimately exposing the post among the user’s network and to others not necessarily interested in vaping. ConclusionsThe borderless nature of social media presents a clear challenge for enforcing Article 13 of the World Health Organization Framework Convention on Tobacco Control, which requires all ratifying nations to implement a ban on tobacco advertising, promotion, and sponsorship. Countering the advertising and promotion of these products is a public health challenge that will require cross-border cooperation with other World Health Organization Framework Convention on Tobacco Control parties. Further research aimed at developing strategies to counter the advertising and promotion of e-cigarettes is therefore needed.

BackgroundAs the majority of Twitter content is publicly available, the platform has become a rich data source for public health surveillance, providing insights into emergent phenomena, such as vaping. Although there is a growing body of literature that has examined the content of vaping-related tweets, less is known about the people who generate and disseminate these messages and the role of e-cigarette advocates in the promotion of these devices. ObjectiveThis study aimed to identify key conversation trends and patterns over time, and discern the core voices, message frames, and sentiment surrounding e-cigarette discussions on Twitter. MethodsA random sample of data were collected from Australian Twitter users who referenced at least one of 15 identified e-cigarette related keywords during 2012, 2014, 2016, or 2018. Data collection was facilitated by TrISMA (Tracking Infrastructure for Social Media Analysis) and analyzed by content analysis. ResultsA sample of 4432 vaping-related tweets posted and retweeted by Australian users was analyzed. Positive sentiment (3754/4432, 84.70%) dominated the discourse surrounding e-cigarettes, and vape retailers and manufacturers (1161/4432, 26.20%), the general public (1079/4432, 24.35%), and e-cigarette advocates (1038/4432, 23.42%) were the most prominent posters. Several tactics were used by e-cigarette advocates to communicate their beliefs, including attempts to frame e-cigarettes as safer than traditional cigarettes, imply that federal government agencies lack sufficient competence or evidence for the policies they endorse about vaping, and denounce as propaganda “gateway” claims of youth progressing from e-cigarettes to combustible tobacco. Some of the most common themes presented in tweets were advertising or promoting e-cigarette products (2040/4432, 46.03%), promoting e-cigarette use or intent to use (970/4432, 21.89%), and discussing the potential of e-cigarettes to be used as a smoking cessation aid or tobacco alternative (716/4432, 16.16%), as well as the perceived health and safety benefits and consequences of e-cigarette use (681/4432, 15.37%). ConclusionsAustralian Twitter content does not reflect the country’s current regulatory approach to e-cigarettes. Rather, the conversation on Twitter generally encourages e-cigarette use, promotes vaping as a socially acceptable practice, discredits scientific evidence of health risks, and rallies around the idea that e-cigarettes should largely be outside the bounds of health policy. The one-sided nature of the discussion is concerning, as is the lack of disclosure and transparency, especially among vaping enthusiasts who dominate the majority of e-cigarette discussions on Twitter, where it is unclear if comments are endorsed, sanctioned, or even supported by the industry.