International Journal of Public Health

, Volume 62, Issue 4, pp 479–487 | Cite as

Geographic variations in electronic cigarette advertisements on Twitter in the United States

Original Article



Studies have identified a proliferation of e-cigarette advertisements on Twitter. We investigate whether the prevalence of e-cigarette related advertising is associated with state tobacco regulations after taking socio-economic characteristics into account.


We collected e-cigarette related tweets from July 23 to October 14, 2015 (n = 757,167) on Twitter. State regulations and smoking prevalence were provided by the Campaign for Tobacco-Free Kids program. The socio-economic data were provided by the American Community Survey.


The number of commercial tweets was 319,041/day with a high potential reach (830,495,700/day). The prevalence of commercial tweets varied significantly by US state. The higher prevalence of e-cigarette advertising was associated with states with better tobacco control impact (r = 0.54, p < 0.0001) and lower youth smoking prevalence (r = −0.39, p = 0.005). In the multivariate analysis, state tobacco control impact is significantly associated with the prevalence of commercial tweets (β = 0.03 ± 0.01, p = 0.02).


Policies at both the federal and state levels are needed to regulate the content of commercial tweets and mitigate the negative effect of social media advertisements.


E-cigarette Commercial Prevalence State regulation Socio-economic factors 


  1. Andler R, Guignard R, Wilquin JL, Beck F, Richard JB, Nguyen-Thanh V (2016) Electronic cigarette use in France in 2014. Int J Public Health 61(2):159–165CrossRefPubMedGoogle Scholar
  2. Ayers JW, Althouse BM, Allem JP, Leas EC, Dredze M, Williams RS (2016) Revisiting the rise of electronic nicotine delivery systems using search query surveillance. Am J Prev Med 50(6):e173–e181CrossRefPubMedGoogle Scholar
  3. Bach L (2015) Key state-specific tobacco-related data & rankings. Campaign for Tobacco-Free Kids, Washington, DCGoogle Scholar
  4. Centers for Disease Control and Prevention (2016) Vital signs: exposure to electronic cigarette advertising among middle school and high school students—United States, 2014. Morb Mortal Wkly Rep 64(52):1403–1408CrossRefGoogle Scholar
  5. Dai H, Hao J (2016a) Exposure to advertisements and susceptibility to electronic cigarette use among youth. J Adolesc Health. doi:10.1016/j.jadohealth.2016.06.013 PubMedGoogle Scholar
  6. Dai H, Hao J (2016b) Mining social media data for opinion polarities about electronic cigarettes. Tob Control. doi:10.1136/tobaccocontrol-2015-052818 Google Scholar
  7. Davis RM, Gilpin EA, Loken B, Viswanath K, Wakefield MA (2008) The role of the media in promoting and reducing tobacco use. National Cancer Institute.
  8. Duggan M, Ellison NB, Lampe C, Lenhart A, Madden M (2015) Social media update 2014. Pew Research Center, Washington, D.C.Google Scholar
  9. Durkin SJ, Biener L, Wakefield MA (2009) Effects of different types of antismoking ads on reducing disparities in smoking cessation among socioeconomic subgroups. Am J Public Health 99(12):2217–2223CrossRefPubMedPubMedCentralGoogle Scholar
  10. Durkin S, Brennan E, Wakefield M (2012) Mass media campaigns to promote smoking cessation among adults: an integrative review. Tob Control 21(2):127–138CrossRefPubMedGoogle Scholar
  11. European Commission (2016) 10 key changes for tobacco products sold in the EU. 20 May 2016. Accessed 12 June 2016
  12. Farrelly MC, Duke JC, Crankshaw EC, Eggers ME, Lee YO, Nonnemaker JM, Kim AE, Porter L (2015) A randomized trial of the effect of e-cigarette TV advertisements on intentions to use e-cigarettes. Am J Prev Med 49(5):686–693CrossRefPubMedGoogle Scholar
  13. Filippidis FT, Laverty AA, Gerovasili V, Vardavas CI (2016) Two-year trends and predictors of e-cigarette use in 27 European Union member states. Tob Control. doi:10.1136/tobaccocontrol-2015-052771 PubMedCentralGoogle Scholar
  14. Giovenco DP, Hammond D, Corey CG, Ambrose BK, Delnevo CD (2015) E-cigarette market trends in traditional US retail channels, 2012–2013. Nicotine Tob Res 17(10):1279–1283CrossRefPubMedGoogle Scholar
  15. Goniewicz ML, Leigh NJ, Gawron M, Nadolska J, Balwicki L, McGuire C, Sobczak A (2016) Dual use of electronic and tobacco cigarettes among adolescents: a cross-sectional study in Poland. Int J Public Health 61(2):189–197CrossRefPubMedGoogle Scholar
  16. Hajek P, Etter JF, Benowitz N, Eissenberg T, McRobbie H (2014) Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction 109(11):1801–1810CrossRefPubMedPubMedCentralGoogle Scholar
  17. Hill S, Amos A, Clifford D, Platt S (2014) Impact of tobacco control interventions on socioeconomic inequalities in smoking: review of the evidence. Tob Control 23(e2):e89–e97CrossRefPubMedGoogle Scholar
  18. Hiscock R, Bauld L, Amos A, Fidler JA, Munafo M (2012) Socioeconomic status and smoking: a review. Ann N Y Acad Sci 1248:107–123CrossRefPubMedGoogle Scholar
  19. Huang J, Kornfield R, Szczypka G, Emery SL (2014) A cross-sectional examination of marketing of electronic cigarettes on Twitter. Tob Control 23(Suppl 3):iii26–iii30CrossRefPubMedPubMedCentralGoogle Scholar
  20. Jo CL, Kornfield R, Kim Y, Emery S, Ribisl KM (2015) Price-related promotions for tobacco products on Twitter. Tob Control. doi:10.1136/tobaccocontrol-2015-052260 Google Scholar
  21. Kim AE, Hopper T, Simpson S, Nonnemaker J, Lieberman AJ, Hansen H, Guillory J, Porter L (2015) Using Twitter data to gain insights into e-cigarette marketing and locations of use: an infoveillance study. J Med Internet Res 17(10):e251CrossRefPubMedPubMedCentralGoogle Scholar
  22. King BA, Patel R, Nguyen KH, Dube SR (2015) Trends in awareness and use of electronic cigarettes among US adults, 2010–2013. Nicotine Tob Res 17(2):219–227CrossRefPubMedGoogle Scholar
  23. Lee JA, Kim SH, Cho HJ (2016) Electronic cigarette use among Korean adults. Int J Public Health 61(2):151–157CrossRefPubMedGoogle Scholar
  24. Leventhal AM, Strong DR, Kirkpatrick MG, Unger JB, Sussman S, Riggs NR, Stone MD, Khoddam R, Samet JM, Audrain-McGovern J (2015) Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA 314(7):700–707CrossRefPubMedPubMedCentralGoogle Scholar
  25. Mello S, Bigman CA, Sanders-Jackson A, Tan AS (2015) Perceived harm of secondhand electronic cigarette vapors and policy support to restrict public vaping: results from a national survey of US adults. Nicotine Tob Res. doi:10.1093/ntr/ntv232 PubMedGoogle Scholar
  26. Primack BA, Soneji S, Stoolmiller M, Fine MJ, Sargent JD (2015) Progression to traditional cigarette smoking after electronic cigarette use among us adolescents and young adults. JAMA Pediatr 169(11):1018–1023CrossRefPubMedPubMedCentralGoogle Scholar
  27. Ramamurthi D, Fadadu RP, Jackler RK (2015) Electronic cigarette marketers manipulate antitobacco advertisements to promote vaping. Tob Control. doi:10.1136/tobaccocontrol-2015-052661 PubMedGoogle Scholar
  28. Sifferlin A (2015) California launches campaign against e-cigarettes. TimeGoogle Scholar
  29. Tan AS, Bigman CA, Sanders-Jackson A (2015a) Sociodemographic correlates of self-reported exposure to e-cigarette communications and its association with public support for smoke-free and vape-free policies: results from a national survey of US adults. Tob Control 24(6):574–581CrossRefPubMedGoogle Scholar
  30. Tan AS, Lee CJ, Bigman CA (2015b) Public support for selected e-cigarette regulations and associations with overall information exposure and contradictory information exposure about e-cigarettes: findings from a national survey of US adults. Prev Med 81:268–274CrossRefPubMedGoogle Scholar
  31. Tax Burden on Tobacco (2014) The tax burden on tobacco. Historical Compilation 49. Accessed 15 Nov 2015
  32. Ungar L, O’Donnell J, Hoyer M (2015) Sickest states do little to snuff out smoking. USA TodayGoogle Scholar
  33. US Department of Health and Human Services (2014) The health consequences of smoking—50 years of progress: a Report of the Surgeon General. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and HealthGoogle Scholar
  34. van der Tempel J, Noormohamed A, Schwartz R, Norman C, Malas M, Zawertailo L (2016) Vape, quit, tweet? Electronic cigarettes and smoking cessation on Twitter. Int J Public Health 61(2):249–256CrossRefPubMedGoogle Scholar
  35. Wellman RJ, O’Loughlin J (2016) E-cigarettes: addressing gaps in knowledge. Int J Public Health 61(2):149–150CrossRefPubMedGoogle Scholar
  36. WHO (2014) Backgrounder on WHO report on regulation of e-cigarettes and similar products. World Health Organization, GenevaGoogle Scholar
  37. Wills TA, Knight R, Sargent JD, Gibbons FX, Pagano I, Williams RJ (2016) Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii. Tob Control. doi:10.1136/tobaccocontrol-2015-052705 Google Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  • Hongying Dai
    • 1
    • 2
    • 3
  • Michael J. Deem
    • 4
    • 5
  • Jianqiang Hao
    • 6
  1. 1.Health Services and Outcomes ResearchChildren’s Mercy HospitalKansas CityUSA
  2. 2.Department of Biomedical and Health InformaticsUniversity of Missouri-Kansas CityKansas CityUSA
  3. 3.Department of PediatricsUniversity of Missouri-Kansas CityKansas CityUSA
  4. 4.Department of Multidisciplinary StudiesIndiana State UniversityTerre HauteUSA
  5. 5.The Center for Genomic AdvocacyIndiana State UniversityTerre HauteUSA
  6. 6.Bellevue UniversityOmahaUSA

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