TY  - JOUR
AU  - Sidani, Jaime E
AU  - Hoffman, Beth
AU  - Colditz, Jason B
AU  - Wolynn, Riley
AU  - Hsiao, Lily
AU  - Chu, Kar-Hai
AU  - Rose, Jason J
AU  - Shensa, Ariel
AU  - Davis, Esa
AU  - Primack, Brian
PY  - 2022
DA  - 2022/4/13
TI  - Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content
JO  - JMIR Form Res
SP  - e26335
VL  - 6
IS  - 4
KW  - COVID-19
KW  - coronavirus
KW  - e-cigarette
KW  - electronic nicotine delivery systems
KW  - Twitter
KW  - social media
KW  - misinformation
KW  - discussion
KW  - public health
KW  - communication
KW  - concern
KW  - severity
KW  - conspiracy
AB  - 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. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2022/4/e26335
UR  - https://doi.org/10.2196/26335
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35311684
DO  - 10.2196/26335
ID  - info:doi/10.2196/26335
ER  -