Journal article
Contextualizing Changes in e-Cigarette Use During the Early COVID-19 Pandemic and Accompanying Infodemic ("So Much Contradictory Evidence"): Qualitative Document Analysis of Reddit Forums
Journal of medical Internet research, Vol.27, e66010
03/20/2025
DOI: 10.2196/66010
PMCID: PMC11969130
PMID: 40112286
Abstract
Understanding how social media platforms facilitate information exchange and influence behavior during health crises can enhance public health responses during times of uncertainty. While some risk factors for COVID-19 susceptibility and severity (eg, old age) were clear, whether e-cigarette use increased risk was not clear. People who used e-cigarettes had to navigate both the COVID-19 infodemic and a conflicting, politicized, and changing information environment about the interaction between COVID-19 and e-cigarette use.
This study aims to characterize and contextualize e-cigarette-related behavior changes during the early COVID-19 pandemic and illuminate the role that social media played in decision-making.
We conducted a qualitative analysis of COVID-19-related e-cigarette discussions on 3 Reddit forums about e-cigarettes. We collected 189 relevant discussion threads made in the first 6 months of the pandemic (collected from June 27, 2020, to July 3, 2020). Threads included 3155 total comments (mean 17 comments) from approximately 1200 unique Redditors. We developed and applied emergent codes related to e-cigarette perceptions and behaviors (eg, the role of nicotine in COVID-19 and do-it-yourself narratives) and web-based community interactions (eg, advice), identified thematic patterns across codes, and developed a model to synthesize the socioecological context of e-cigarette behaviors.
e-Cigarette subreddits provided a platform for Redditors to discuss perceptions and experiences with e-cigarettes, make sense of information, and provide emotional support. Discussions reflected an array of e-cigarette-related behavioral responses, including increases and decreases in use intensity, changes in purchasing practices (eg, stockpiling), and changes in vaping practices (eg, reusing disposable pods). This study presented a theoretically and empirically informed model of how circumstances created by the pandemic (eg, changes in activity space and product shortages) compelled behavior changes. Redditors drew from their existing perceptions, intentions, and experiences with nicotine and tobacco products; their personal pandemic experiences; and their participation on Reddit to decide whether and how to change their e-cigarette behaviors during the early pandemic. Forums reflected uncertainty, stress, and debate about the rapidly evolving and complicated public health information. Consumption and discussion of media (eg, news articles and peer-reviewed publications) on Reddit informed e-cigarette perceptions and behaviors. Decisions were complicated by distrust of the media.
Variations in individual traits and environmental circumstances during the early COVID-19 pandemic provide context for why there was no unified direction of e-cigarette behavior change during this period. Information and discussion on Reddit also informed risk perceptions and decisions during the pandemic. Social media is an effective and important place to communicate public health information, particularly during crisis or disaster situations. Moving forward, transparent, accurate, and specific message development should consider the stress, struggles, and stigma of people who use e-cigarettes and address the roles mistrust and misinformation play in decisions.
Details
- Title: Subtitle
- Contextualizing Changes in e-Cigarette Use During the Early COVID-19 Pandemic and Accompanying Infodemic ("So Much Contradictory Evidence"): Qualitative Document Analysis of Reddit Forums
- Creators
- Shannon Lea Watkins - University of IowaKatherine Snodgrass - University of IowaLexi Fahrion - University of IowaEmily Shaw - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of medical Internet research, Vol.27, e66010
- DOI
- 10.2196/66010
- PMID
- 40112286
- PMCID
- PMC11969130
- NLM abbreviation
- J Med Internet Res
- ISSN
- 1438-8871
- eISSN
- 1438-8871
- Publisher
- JMIR PUBLICATIONS, INC
- Grant note
- American Cancer Society: IRG 18-165-43 University of Iowa Office of Undergraduate ResearchUniversity of Iowa College of Public Health
The authors express gratitude to Minji Kim, Alyssa Bercasio, and Kamara Shaw for their help, support, and feedback on this work and to the Redditors for sharing their insights and experiences during this unprecedented time. This work was supported by the American Cancer Society (IRG 18-165-43) , administered through the Holden Comprehensive Cancer Center at the University of Iowa, the University of Iowa Office of Undergraduate Research, and the University of Iowa College of Public Health. KS conducted this work as an undergraduate student at the University of Iowa. ES and LF completed this work as Master's of Public Health students at the University of Iowa.
- Language
- English
- Date published
- 03/20/2025
- Academic Unit
- Community and Behavioral Health
- Record Identifier
- 9984801617102771
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