A cross-sectional examination of marketing of electronic cigarettes on Twitter

BACKGROUND: Rapid increases in marketing of e-cigarettes coincide with growth in e-cigarette use in recent years; however, little is known about how e-cigarettes are marketed on social media platforms. METHODS: Keywords were used to collect tweets related to e-cigarettes from the Twitter Firehose between 1 May 2012 and 30 June 2012. Tweets were coded for smoking cessation mentions, as well as health and safety mentions, and were classified as commercial or non-commercial ('organic') tweets using a combination of Naïve Bayes machine learning methods, keyword algorithms and human coding. Metadata associated with each tweet were used to examine the characteristics of accounts tweeting about e-cigarettes. RESULTS: 73,672 tweets related to e-cigarettes were captured in the study period, 90% of which were classified as commercial tweets. Accounts tweeting commercial e-cigarette content were associated with lower Klout scores, a measure of influence. Commercial tweeting was largely driven by a small group of highly active accounts, and 94% of commercial tweets included links to websites, many of which sell or promote e-cigarettes. Approximately 10% of commercial and organic tweets mentioned smoking cessation, and 34% of commercial tweets included mentions of prices or discounts for e-cigarettes. CONCLUSIONS: Twitter appears to be an important marketing platform for e-cigarettes. Tweets related to e-cigarettes were overwhelmingly commercial, and a substantial proportion mentioned smoking cessation. E-cigarette marketing on Twitter may have public health implications. Continued surveillance of e-cigarette marketing on social media platforms is needed.