International Journal of Public Health

, Volume 62, Issue 4, pp 479–487

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

Original Article

DOI: 10.1007/s00038-016-0906-9

Cite this article as:
Dai, H., Deem, M.J. & Hao, J. Int J Public Health (2017) 62: 479. doi:10.1007/s00038-016-0906-9



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 

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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