(Reuters Health) - Tracking tweets and monitoring chat groups could shed light on the soaring popularity and use of the flash drive-shaped Juul e-cigarette, researchers say.
“Juul has become a cultural phenomenon and has been called the ‘iPhone of electronic cigarettes’ among some media outlets,” lead study author Ramakanth Kavuluru told Reuters Health. “You know it’s a phenomenon when people start dressing up as it for Halloween.”
Although the device is restricted to ages 21 and older, Kavuluru’s team found by analyzing social media conversations that underage users have ways to buy Juul, and often use the devices secretly at home and at school.
“Juul came onto our radar last fall, and we started tracking it on Twitter, where social media chatter among teens is not as inhibited as on Facebook, where their parents may be,” Kavuluru said in a telephone interview.
Introduced in 2015, Juul is the most popular e-cigarette with nearly 50 percent market share as of January 2018, the study team notes. Charged via USB, the device comes with disposable pods containing a 5-percent nicotine liquid, with each pod said to be roughly equivalent to one pack of cigarettes or 200 puffs from traditional cigarettes. Although Juul is advertised for adult smokers seeking an alternative to cigarettes, many young people who have never smoked have taken to the device.
According to a research letter in the journal Tobacco Control, Kavuluru and colleagues analyzed more than 250,000 messages on Twitter and Reddit between October 2017 and February 2018.
On Twitter, about one third of the posts were original tweets, and the rest were retweets by others. On this platform in particular, Juul was frequently used as a verb, as in “trying to Juul in the bathroom,” the researchers note.
“It’s an activity that people can do together,” Kavuluru said. “It makes them feel like they belong to a group and can relax together.”
Juul mentions were also often associated with school sites and concealed places in those locations, such as bathrooms, toilets or locker rooms, the researchers found. Nearly 8,000 tweets mentioned Christmas and Valentine’s Day gifts related to Juul, with some users hoping for pods as gifts.
Another nearly 1,800 unique tweets contained terms related to nicotine dependence, including the words crave, addiction, addicted. Several Twitter users mentioned they were addicted to Juul, often in a light-hearted manner, and others said they were glad they’re not addicted.
On Reddit, the research team found a topical forum, known as a subreddit, with more than 15,000 members discussing Juul-related themes. They also found a group for underage users that started in July 2017 and was banned in January 2018. While it lasted, this group’s users messaged about retailers that don’t require age verification, and older users offered “discreet shipping” of the product to teens willing to pay a higher price via online payment sites.
“Although the underage Juul subreddit is banned, there could be other more private online forums where similar information can be exchanged among underage users, posing a major challenge for surveillance,” the study authors write. “While it was active, the underage subreddit provided a peek into the inner workings of how social networks can lead to easier access to tobacco products.”
Based on their four-month experiment, Kavuluru of the University of Kentucky in Lexington and his colleagues suggest that researchers and regulators can also use social media to study patterns of Juul use and to target public health messages directly to teens.
In late April, the U.S. Food and Drug Administration launched a crackdown on sales to minors and Juul's manufacturer announced it would spend $30 million to help develop a framework for research into the scientific and social implications of vapor products as well as evaluating technologies to prevent youth from accessing and using Juul products (reut.rs/2IFgnR9).
“The surge in popularity happened so quickly that the (FDA) was not able to keep up on research and regulations,” said Amanda Morrill, an assistant professor of pharmacy practice at MCPHS University in Boston, who was not involved in the study.
“E-cigarettes are the latest public health risk, and we need to educate high school students about them,” she said in a telephone interview. “Anyone using these products now are the guinea pigs as we learn in the next 15-20 years how they really affect us.”
SOURCE: bit.ly/2k0Q21R Tobacco Control, online April 13, 2018.