%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 6
%N 4
%P e26335
%T Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content
%A Sidani,Jaime E
%A Hoffman,Beth
%A Colditz,Jason B
%A Wolynn,Riley
%A Hsiao,Lily
%A Chu,Kar-Hai
%A Rose,Jason J
%A Shensa,Ariel
%A Davis,Esa
%A Primack,Brian
%+ Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, United States, 1 412 383 0733, jaime.sidani@pitt.edu
%K COVID-19
%K coronavirus
%K e-cigarette
%K electronic nicotine delivery systems
%K Twitter
%K social media
%K misinformation
%K discussion
%K public health
%K communication
%K concern
%K severity
%K conspiracy
%D 2022
%7 13.4.2022
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS) are increasing. Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the e-cigarette or vaping product use–associated lung injury (EVALI) outbreak of 2019 was actually an early presentation of COVID-19. This may have important public health ramifications for both COVID-19 control and ENDS use. Objective: Twitter is an ideal tool for analyzing real-time public discussions related to both ENDS and COVID-19. This study seeks to collect and classify Twitter messages (“tweets”) related to ENDS and COVID-19 to inform public health messaging. Methods: Approximately 2.1 million tweets matching ENDS-related keywords were collected from March 1, 2020, through June 30, 2020, and were then filtered for COVID-19–related keywords, resulting in 67,321 original tweets. A 5% (n=3366) subsample was obtained for human coding using a systematically developed codebook. Tweets were coded for relevance to the topic and four overarching categories. Results: A total of 1930 (57.3%) tweets were coded as relevant to the research topic. Half (n=1008, 52.2%) of these discussed a perceived association between ENDS use and COVID-19 susceptibility or severity, with 42.4% (n=818) suggesting that ENDS use is associated with worse COVID-19 symptoms. One-quarter (n=479, 24.8%) of tweets discussed the perceived similarity/dissimilarity of COVID-19 and EVALI, and 13.8% (n=266) discussed ENDS use behavior. Misinformation and conspiracy theories were present throughout all coding categories. Conclusions: Discussions about ENDS use and COVID-19 on Twitter frequently highlight concerns about the susceptibility and severity of COVID-19 for ENDS users; however, many contain misinformation and conspiracy theories. Public health messaging should capitalize on these concerns and amplify accurate Twitter messaging. 
%M 35311684
%R 10.2196/26335
%U https://formative.jmir.org/2022/4/e26335
%U https://doi.org/10.2196/26335
%U http://www.ncbi.nlm.nih.gov/pubmed/35311684