Electronic cigarettes have become a worldwide trend, especially among young adults. A new study published in Frontiers in Communication said that promotional vaping Instagram posts outnumber anti-vaping content 10,000 to 1. Despite “The Real Cost” awareness campaign launched by the Food and Drug Administration (FDA) in 2018, nearly one third of American teenagers are estimated to use e-cigarettes. The current study highlights the limited impact of the FDA campaign, while also using deep learning – an artificial intelligence method – to better understand marketing tactics used by vaping companies. "US public health officials have been calling vaping among youth an epidemic and have been putting a lot of effort into trying to stop this epidemic by introducing #TheRealCost anti-vaping campaign,” said Julia Vassey of the University of California, Berkeley, US. "But this stark imbalance in the volume of posts has caused the FDA message to be overwhelmed by marketing from the vaping brands," she added. Many teenagers continue to view e-cigarettes as a healthier option than conventional cigarettes, but vaping is associated with inflammation, reduced immune responses, and breathing troubles. To further understand how vaping is perceived on social media, Vassey and her collaborators at the UC Berkeley Center for Integrative Research on Childhood Leukemia and the Environment (CIRCLE) collected 245,894 Instagram posts spanning from before and after the #TheRealCost campaign launch. The team also conducted interviews with five vaping influencers and eight college-age social media users. “We focused on Instagram because the vaping influencers we interviewed for this study identified Instagram as their most important social media marketing platform,” explained Vassey, adding that “based on the results, the FDA anti-vaping campaign is not very popular and we saw Instagram user comments disputing the FDA claims of damaging health effects from nicotine and calling the campaign propaganda.” In contrast to the FDA's intentions, Vassey and her colleagues found that vaping posts received nearly three times more “likes” after the campaign launch. They also found that there were six times as many posts that had over 100 likes. Importantly, participants in the focus groups additionally suggested that anti-vaping campaign promoted scare tactics rather than offering guidance on how to quit vaping. By analysing common themes across Instagram images, researchers found that over 70% contained e-juices and devices, which contain higher nicotine concentrations and are often popular among e-cigarette novices. The analytics data shared by the vaping influencers also showed that many of their followers were underage (13 to 17 years old). The results of this study were limited to Instagram content (as opposed to other social media outlets) and the researchers plan to investigate how content translates to actual vaping use next. "We're hoping the findings will inform public health regulators about the most popular channels used by vaping influencers to promote vaping content among underage population in order to help counter e-cigarette marketing and slow vaping proliferation among youth,” said Vassey. "This study could also contribute to providing direction for future federal and local public health anti-vaping intervention campaigns." According to a previous study published by researchers from the University of Pittsburgh, published in the American Journal of Medicine, young adults who use electronic cigarettes are more than four times as likely to begin smoking tobacco cigarettes within 18 months as their peers who do not vape. The World Health Organization estimates that tobacco kills up to one half of its regular users via cardiovascular disease, lung and other cancers, and respiratory illnesses. The researchers believe that e-cigarettes are serving as a gateway to traditional smoking. The study is the first US nationally representative survey that followed, for more than a year, people aged 18 to 30 years old who were initially non-smokers. To do so, the researchers analysed a survey of US adults who were randomly selected in March 2013 to complete a questionnaire about their tobacco use. Eighteen months later, in October 2014, 915 participants who said they had never smoked cigarettes completed a follow-up survey. Depending on the results of the survey, the team applied “weights” to the results by over and under-emphasising the answers of the survey participants in order to arrive at findings that would be more representative of the true makeup of the US population. The findings of the study showed that only 14.2% of those surveyed were Hispanic, so the team over-emphasised their answers so that the weighted sample and final results were 19.7% Hispanic. According to the results of the final weighted survey, the researchers demonstrated that 11.2% of participants (none of whom had ever smoked when they completed the initial questionnaire) had started smoking tobacco cigarettes. Of participants who said they vaped e-cigarettes in the first questionnaire, 47.7% had started smoking cigarettes 18 months later, compared to 10.2% of those who did not use e-cigarettes. Without the survey weights to make the sample representative of the US population, 37.5% of e-cigarette users had started smoking cigarettes 18 months later, compared to 9% of those who didn't use e-cigarettes, the study reveals. “Early evidence on the potential value of e-cigarettes for cessation or reduction of cigarette smoking has been mixed,” said lead author Brian A. Primack, director of Pitt's Center for Research on Media, Technology and Health, and Dean of Pitt's Honors College. Primack told Daily News Egypt, “Our study finds that in non-smokers, e-cigarettes make people more likely to start smoking. This supports policy and educational interventions designed to decrease the use of e-cigarettes among non-smokers, and suggest that clinicians who treat e-cigarette users should counsel them both about their potential for harm and about the high risk of transitioning to tobacco cigarettes among initial non-smokers." Primack said that young adulthood is an important time when people establish whether they use tobacco or not. He added that more research will be needed to determine why e-cigarettes increase the risk of someone transitioning to tobacco cigarettes. According to the lead author, several factors are likely at play, including that using e-cigarettes mimics the behaviour of smoking traditional cigarettes, the sweet vape is a gentle introduction to smoking harsher tobacco, and the build-up of nicotine addiction could lead e-cigarette users to seek out more nicotine-packed tobacco cigarettes.
