The spread of misinformation on Twitter regarding vaping

In a recent study published in the Journal of Medical Internet Research, researchers examine the discourse of misinformation related to electronic nicotine delivery systems (ENDS) on social media. Pro-vaping and anti-vaping narratives were evaluated to identify key actors involved in spreading or countering such misinformation.

Study: Twitter Misinformation Discourses About Vaping: Systematic Content Analysis. Image Credit: FOTOGRIN /


ENDS, which are also known as e-cigarettes or vapes, have become popular among both former smokers and new nicotine users, particularly among the youth. In the United States (U.S.), ENDS usage among middle and high school students increased from 10% in 2011 to over 27% by 2019. This increase is alarming due to the health risks associated with vaping, such as respiratory and cardiovascular issues, and potentially cancer.

Since 2015, e-cigarettes have been the most commonly used tobacco product in the U.S. This has increased concerns from the public health community about the health effects of vaping, particularly among adolescents who might transition to traditional cigarettes due to nicotine addiction. Further research is needed to understand how misinformation about ENDS on social media, particularly Twitter, influences public perception and decision-making, especially given the rapid rise in ENDS use among youth and its associated health risks.

About the study 

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

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

For content analysis, the researchers developed a codebook through emergent coding. This codebook focused on the tweet’s stance towards vaping, discussed topics, and actors implicated in spreading misinformation.

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

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

Explicit accusations of misinformation were necessary for a tweet to be coded as misinformation. This refined methodology led to high intercoder reliability, as measured by Krippendorff’s alpha scores.

In addition to manual coding, the digital tool QDA Miner-WordStat9 was used to extract further insights from the tweets. This method enabled the researchers to identify prevalent words, phrases, and their interrelations, thus aiding in understanding the dominant themes in the discourse.

From an ethical standpoint, 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 findings 

In the present comprehensive study examining Twitter discourse on vaping, 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 sentiments.

This bias was reflected in audience engagement as well, with nearly all interactions at 99.6% involving pro-vaping content. Pro-vaping tweets averaged higher engagement as compared to anti-vaping tweets.

The most prevalent topic in these tweets was the safety of vaping, followed by discussions on COVID-19, body autonomy, policy actions, and economic issues related to vaping. Despite being a frequent subject, claims of vaping’s safety attracted less engagement per tweet as compared to other topics. Moreover, tweets on the harmful effects of vaping, though few, garnered significant engagement per tweet.

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

News media were often accused of spreading misinformation in pro-vaping tweets, with specific outlets like Cable News Network (CNN) and Bloomberg frequently mentioned. In contrast, anti-vaping tweets targeted different media outlets, primarily those with conservative views. Public health authorities and government figures were also frequently implicated in spreading misinformation, according to pro-vaping narratives.

Economic discussions in pro-vaping tweets focused on the negative effects of vaping bans, such as job losses and the closure of small businesses. These tweets often accused governments and political interests of spreading misinformation to benefit tobacco companies. The Master Settlement Agreement was a recurring theme in these accusations, with claims that it was being used for revenue rather than tobacco control.

Calls for policy action varied 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 bans and promoting better regulation to prevent the sale of unsafe products.

Advertising and promotion of vaping products also featured heavily in the discourse. Pro-vaping tweets often accused anti-vaping advocates of spreading misinformation, while also promoting vaping products themselves. Some pro-vaping tweets used the term “fake news” to discredit competitors or advocate for vaping.

A minor but notable aspect of the discourse involved accusations against the tobacco industry, with some tweets from both sides accusing it of spreading misinformation. The researchers noted efforts within pro-vaping tweets to influence politics by using hashtags to encourage voting and exert political pressure.

Journal reference:
  • Al-Rawi, A., Blackwell, B., Zemenchik, K., et al. (2023) Twitter Misinformation Discourses About Vaping: Systematic Content Analysis. Journal of Medical Internet Research. doi:10.2196/49416
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