The spread of misinformation on Twitter regarding vaping

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In a recently published study, Dr Journal of Medical Internet Research, researchers examined misinformation discourse about electronic nicotine delivery systems (ENDS) on social media. Pro-vaping and anti-vaping narratives were assessed to identify key actors involved in spreading or preventing such misinformation.

Study: Twitter misinformation discussions about vaping: Systematic content analysis. Image credit: FOTOGRIN/


ENDS, also known as e-cigarettes or vapes, have become popular among ex-smokers and new nicotine users, especially youth. In the United States (US), ENDS use among middle and high school students increased from 10% in 2011 to over 27% by 2019. This increase is alarming given the health risks associated with vaping, such as respiratory and cardiovascular problems. Possible cancer.

Since 2015, e-cigarettes have become the most widely used tobacco product in the United States.This has raised concerns in the public health community about the health effects of vaping, particularly among adolescents who may convert to traditional cigarettes due to nicotine addiction. More research is needed to understand how misinformation about ENDS on social media, particularly Twitter, influences public perception and decision-making, especially given the rapid increase in ENDS use among youth and its associated health risks.

About the study

Researchers used Twitter’s academic application programming interface (API) to collect more than 6.6 million tweets between August 2006 and August 2022 containing the #vape and #vaping hashtags. This dataset, which represents all available relevant tweets on Twitter during this period, was chosen due to Twitter’s historical API access, which was closed after Elon Musk’s acquisition.

A Python script was used to filter tweets mentioning terms such as “fact check”, “misinformation” and “fake news” in the context of vaping. This narrowed down the dataset to 10,057 tweets from 2,925 users. Further refinement by removing retweets and non-English content led to a total of 2,945 tweets, with significant audience participation.

For content analysis, researchers developed a codebook through emergent coding. This codebook focuses on the position of tweets toward actors involved in vaping, hot topics, and spreading misinformation.

Six main topic and seven actor categories were identified and included public health authorities, news media, government agencies, advocacy groups, health experts, industry representatives and other influential figures. These categories reflect a pattern of users attributing inaccurate information to specific sources.

To ensure reliability, a sample of tweets was coded independently by two coders. After initial low agreement, the team refined their approach and incorporated hashtag analysis to improve context understanding and intercoder agreement.

A clear allegation of misinformation was required for a tweet to be coded as misinformation. This refined method led to high intercoder reliability as measured by Krippendorff’s alpha score.

In addition to manual coding, the digital tool QDA Miner-WordStat9 was used to extract more insights from the tweets. This approach enables researchers to identify common words, phrases and their interrelationships, thus helping to understand dominant themes in discourse.

From an ethical perspective, the current study was considered non-intrusive, as it analyzed publicly available social media content and did not require ethics clearance from the university. To ensure privacy, the researchers excluded identifiable user information and Twitter hyperlinks from their analysis.

Study results

In the current comprehensive study examining Twitter discourse related to vaping, the researchers discovered an overwhelming dominance of pro-vaping positions in the analyzed tweets. Of the tweets examined, 98.9% supported vaping, with only 1.1% expressing anti-vaping sentiment.

This bias was also reflected in audience engagement, with nearly 99.6% of all interactions involving pro-vaping content. Pro-vaping tweets averaged more engagement than anti-vaping tweets.

The most prevalent topic in these tweets was the safety of vaping, followed by discussions of COVID-19, body autonomy, policy actions, and economic issues related to vaping. Despite being a frequent topic, vaping safety claims attract less engagement per tweet than other topics. Furthermore, tweets about the harmful effects of vaping, although low, garnered significant engagement per tweet

Public health authorities (PHA) and the media were the most engaged actors in these discussions, followed by government figures and other organizations. Although public health experts were mentioned less frequently, they received higher engagement per tweet.

The news media was often accused of spreading misinformation in pro-vaping tweets, with certain outlets such as Cable News Network (CNN) and Bloomberg. In contrast, anti-vaping tweets target various media outlets, primarily those with conservative views. Public health authorities and government statistics were also often involved in spreading misinformation, according to pro-vaping narratives.

Pro-vaping tweets discuss the negative effects of vaping bans, such as job losses and small business closures. These tweets often accuse governments and political interests of spreading misinformation to benefit tobacco companies. The Master Settlement Agreement was a recurring theme of these complaints, with claims that it was being used for revenue rather than tobacco control.

Calls for policy action differed between pro- and anti-vaping tweets. Whereas anti-vaping tweets called for stricter regulations and awareness of vaping risks, pro-vaping tweets focused on opposing the ban and promoting better regulation to prevent the sale of unsafe products.

Advertising and promotion of vaping products also featured heavily in the speech. Pro-vaping tweets often accuse anti-vaping advocates of spreading misinformation, while also promoting vaping products. Some pro-vaping tweets use the term “fake news” to disparage competitors or advocate vaping.

A small but significant aspect of the speech involved accusations against the tobacco industry, with some tweets from both sides accusing it of spreading misinformation. Researchers noted efforts among pro-vaping tweets to influence politics by using hashtags to encourage votes and exert political pressure.

Journal Reference:

  • Al-Rawi, A., Blackwell, B., Zemenchik, K., etc (2023) Twitter misinformation discussions about vaping: systematic content analysis. Journal of Medical Internet Research. doi:10.2196/49416

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