E-cigarettes, also known as vaping pens or e-hookas, are commonly advertised on Twitter and the tweets often link to commercial websites promoting e-cig use, according to University of Illinois at Chicago researchers.
The study, published as a special supplement in the July 2014 issue of Tobacco Control released online June 16, has implications for future FDA regulations on the marketing of e-cigarettes and related products.
"There's this whole wild west of social media platforms - Facebook, Twitter and Instagram - and the FDA has no way to track what's happening in those platforms," said Jidong Huang, senior research scientist at UIC's Institute for Health Research and Policy and lead author of the study.
While advertising for conventional cigarettes has long been prohibited, e-cigarettes are advertised routinely in traditional media (print, television and radio) and social media.
The researchers collected tweets and metadata related to e-cigarettes during a two month period in 2012. Using novel statistical methodology and carefully chosen keywords, they captured more than 70,000 tweets related to e-cigs.
Among those 70,000 tweets, nearly 90 percent were commercial tweets and only 10 percent were 'organic,' or individual consumer opinions. Fully 94 percent of the commercial tweets included a website link, while only 11 percent of the organic tweets did.
Of the commercial tweets, 11 percent mentioned quitting smoking, and more than one-third offered coupons or discounts to purchase e-cig products.
Although only 11 percent of commercial tweets referenced smoking cessation, the absolute number is significant, Huang said, if considered over longer timeframes than the two months of the study.
Twitter is the second-largest search engine after Google.
"If kids or youth search for 'vaping pen' or 'e-cig' on Twitter, they will get links to commercial sites where they can purchase these items," said Huang. Unlike Facebook and some other platforms where one can set privacy controls, all information on Twitter is accessible to anyone.
Previous research has demonstrated rapid growth in use and awareness of e-cigarettes among adults and youth in recent years. However, there is limited evidence related to the products' long-term health impact, efficacy in smoking cessation -- or role as a "gateway" to other tobacco products.
"We know very little about what these products are made of and what kind of chemicals are in the e-juice," Huang said.
The study did not look at who was exposed to the messages, but it is known that Twitter users are primarily young adults (30 percent ages 18-29) and African American (27 percent) or Latino (28 percent).
"Given the substantial youth presence on social media, the marketing of e-cigarettes on those platforms may entice non-smokers - youth in particular - to experiment with and initiate e-cigarette use," write the authors.
Huang's coauthors are Rachel Kornfield, Glen Szcypka and Sherry Emery, all of UIC.