To better understand adverse events associated with vaping, this project conducted in-depth discussions with current and former e-cigarette users California ages 18-29 years old to discuss their experiences with vaping-related adverse experiences and used digital surveillance to identify reports of adverse events on social media platforms. Funding for this project was provided by the California Tobacco-Related Disease Research Program.
Vaping adverse events are unwanted or negative side effects from vaping. While there can be hundreds or thousands of chemicals inhaled while vaping, nicotine is particularly notable for its addictive quality. Nicotine sickness, or "nic-sick" refers to non-specific symptoms of exposure to nicotine. Common symptoms include headaches, irritation of the mouth and throat, nausea, stomachache, and shortness of breathe. More serious symptoms include confusion or anxiety, vomiting, tremors, and impacts on blood pressure.
The purpose of this study is to uncover, characterize and better understand the health effects and contextual factors associated with adverse events for e-cigarettes. Online focus groups with young adults in California were held to discuss adverse experiences associated with vaping in three major CA cities with young adults. Data science methods were used to establish a big data digital surveillance approach to collect user discussions from multiple social media platforms popular among young adults to identify and characterize adverse events.
Our preliminary findings show a wide range of adverse experiences are reported by young adults who use e-cigarettes, including headache, nausea, dry/sore throat, and lightheadedness which often result in cutting back use. Only a few adverse events such as shortness of breath and chest pain reportedly prompted users to plan to or actually quit vaping.
Improved surveillance and regulation of e-cigarette use is needed to ensure risks associated with their use are minimized.
King JL, Reboussin BA, Wiseman KD, Ribisl KM, Seidenberg AB, Wagoner KG, et al. Adverse
symptoms users attribute to e-cigarettes: Results from a national survey of US adults. Drug Alcohol
Chen I-L. FDA Summary of Adverse Events on Electronic Cigarettes. Nicotine Tob Res. 2013
Pénzes M, Bakacs M, Brys Z, Vitrai J, Tóth G, Berezvai Z, Urbán R. Vaping-Related Adverse Events
and Perceived Health Improvements: A Cross-Sectional Survey among Daily E-Cigarette Users. Int J
Environ Res Public Health. 2021 Aug 5;18(16):8301. doi: 10.3390/ijerph18168301. PMID:
34444050; PMCID: PMC8394644.
This section includes academic papers that have been published, are in press, are under review, or are in progress
Authors: Bardier C, Yang J, Li J, Mackey TK
Journal: BMC Research Notes
Year Published: 2021
Type: Original Research
The objective of this study was to develop an inductive coding approach specific to characterizing user-generated social media conversations about transition of use of different tobacco and alternative and emerging tobacco products (ATPs).
A total of 40,206 tweets were collected from the Twitter public API stream that were geocoded from 2018 to 2019. Using data mining approaches, these tweets were then filtered for keywords associated with tobacco and ATP use behavior. This resulted in a subset of 5718 tweets, with 657 manually annotated and identified as associated with user-generated conversations about tobacco and ATP use behavior. The 657 tweets were coded into 9 parent codes: inquiry, interaction, observation, opinion, promote, reply, share knowledge, use characteristics, and transition of use behavior. The highest number of observations occurred under transition of use (43.38%, n=285), followed by current use (39.27%, n=258), opinions about use (0.07%, n=46), and product promotion (0.06%, n=37). Other codes had less than ten tweets that discussed these themes. Results provide early insights into how social media users discuss topics related to transition of use and their experiences with different and emerging tobacco product use behavior.
Citation: Bardier C, Yang J, Li J, Mackey TK. Characterizing Alternative and Emerging Tobacco Product Transition of Use Behavior on Twitter. BMC Res Notes. 2021;14:303
Authors: Bardier C, Purushothaman V, McMann T, Nali M, Li Z, Cuomo RE, Mackey TK
TikTok is a micro-video social media platform experiencing exponential
growth with 60% of its monthly users between ages 16-24. Recent studies have found that increased exposure to e-cigarette content on social media may influence patterns of use. However, there is limited research assessing the characteristics of nicotine poisoning-related content posted on social media.
To assess the characteristics of nicotine-related content on TikTok.
The study collected TikTok posts associated with the #nicsick hashtag and
used inductive coding to conduct content analysis for video characteristics. Videos weremanually annotated to generate a codebook of nicotine sickness-related themes. Statistical analysis was used to compare continuous characteristics of videos with and without active nicotine sickness TikTok topics.
A total of 132 TikTok videos with the hashtag #nicsick were manually coded,
with 52.3% (n=69) identified as discussing first-hand and second-hand reports of suspected nicotine poisoning symptoms. Among these videos were users who documented their experiences with adverse events and users actively vaping. Videos depicting adverse events and/or nicotine poisoning symptoms were longer in duration than those for other #nicsick-related topics (P=.08).
TikTok users openly discuss experiences, both firsthand and secondhand,
with nicotine adverse events via the #nicsick hashtag. Exposure to promotional e-cigarette social media content may facilitate overconsumption of nicotine, leading to nicotine poisoning. The appeal of “going viral” may encourage TikTok users to spread novel and potentially dangerous e-cigarette use patterns in addition to discussions and experiences with nicotine poisoning.
Authors: Purushothaman V, Bardier C, McMann T, Li Z, Cuomo RE, Mackey TK
This section includes oral and poster presentations at conferences, news and media coverage, and other research dissemination activities
Authors: Cuomo, RE, Mackey TK
Characterization of ENDS industry coordination and influence on CA tobacco control policy on Facebook
Xu Q, Yang J, Cai M, Haupt M, Nali M, Mackey TK
This section includes project datasets that can be downloaded for further research purposes. Due to different restrictions, some of the data has had fields removed. For details please contact study team