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E-cigarette use in the United States has significantly grown in recent years. Widespread diffusion of e-cigarette content across social media communities may be contributing to this growth. In this study, we (1) explored topics related to e-cigarettes and vaping on Reddit and (2) examined the extent to which these topics clustered across distinct communities. We analyzed a total of N = 79,783 Reddit submissions posted between March 2017 and February 2018 that mentioned at least one e-cigarette or vaping keyword. We created a dictionary to classify submissions into seven different topics related to e-cigarettes and vaping. Submissions were also categorized into one of six mutually exclusive communities identified using subreddit meta-data. Our results indicate that e-cigarette and vaping content on Reddit is primarily about the buying and selling of e-cigarette products. Other common topics included how to build vaping devices, e-juice, and e-cigarette advice. Network correlation analyses found that the distribution of our seven identified topics varied significantly among general e-cigarette, drugs, and research/news subreddit communities. Findings from this study add to a growing literature investigating e-cigarettes and vaping on social media and also contribute to network-level theories by linking communities on Reddit to the diffusion of various depictions of e-cigarettes and vaping.

We sought to examine the relationship between perceived message effectiveness (PME) and actual message effectiveness (AME) in a 3-week randomized trial of vaping prevention advertisements. Participants were US adolescents (n = 1,514) recruited in 2021. We randomly assigned them to view The Real Cost vaping prevention ads or control videos online. Participants viewed three videos at Visit 1, again at Visits 2 and 3, and completed a survey at each visit that assessed AME (susceptibility to vaping) and two types of PME – effects perceptions (potential for behavioral impact) and message perceptions (potential for message processing). At Visit 4, AME was measured. Compared to control, The Real Cost ads led to improved AME (lower susceptibility to vaping at Visit 4, p <.001). This was anticipated by The Real Cost ads eliciting higher PME ratings (higher effects and message perceptions at Visit 1, both p <.001). Furthermore, PME (both effects and message perceptions) at Visit 1 predicted susceptibility to vaping at Visits 1, 2, 3, and 4 (all p <.001). Finally, effects perceptions fully mediated the impact of The Real Cost ads on susceptibility to vaping (β = −.30; p <.001), while message perceptions only partially mediated the effect (β = −.04; p =.001). Our findings indicate a relationship between PME and AME, especially effects perceptions, and suggest that PME may be useful in message pre-testing to select messages with greater behavior change potential. [ABSTRACT FROM AUTHOR]

Introduction:Use of telehealth increased during the COVID-19 pandemic and continues to be a popular health resource. This study analyzed the frequency and sentiment of telehealth discussions on Reddit. Methods:The data set included 13,071 publicly available Reddit submissions containing keywords related to telehealth over a 3-year period. We identified 173 unique subreddit communities, which were coded into mutually exclusive categories: (1) general telehealth, (2) individual care, (3) professional, (4) news, and (5) COVID-19. The Vader lexicon-based machine was used to assign sentiment scores. Results:Most subreddits were coded as individual care (n = 112), professional (n = 26), and news (n = 22). The frequency of submissions increased during the first 2 months of the pandemic and dropped in June 2020, but remained consistent through October 2022. Most Reddit submissions were positive in sentiment (56%). Conclusion:Findings show a mostly positive view of telehealth among Reddit users and an increase in telehealth-related discussions since the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Awareness of risk for oropharyngeal cancer from oral human papillomavirus (HPV) infection is low among men in the United States. This pilot study tested messages communicating oral HPV and oropharyngeal cancer risk among a sample of U.S. young adult men (aged 18–26). Six oral HPV and cancer risk messages were tested in an online survey. Participants (N = 68) were randomly assigned to one of two message sets, each containing three unique text-based messages. Participants evaluated messages separately based on various measures (e.g., perceived message effectiveness [PME], novelty). One-way repeated measures ANOVAs were used to assess evaluation differences within message sets. Participants provided open-ended feedback about each message, which were synthesized into overarching themes. Participants were receptive to the risk messages, rating them high on PME (mean range = 3.72–4.25 out of 5) and other measures. Analyses identified three high-performing messages. For example, participants rated a message about HPV-linked oropharyngeal cancer risk rates in men versus women higher on attention and novelty than two other messages in the same set (both p s <.05). Participants were shown three messages (instead of all six) in each message set to minimize survey fatigue. Common themes from open-ended feedback were that participants liked the short-form structure of the messages and that the messages used gender-tailored language. In conclusion, oral HPV and oropharyngeal cancer risk messages may be useful for increasing risk awareness among men in the U.S. Further work should test such messages in rigorous experimental contexts to assess their efficacy in modifying other health outcomes, such as HPV vaccination behaviors. [ABSTRACT FROM AUTHOR]

Reddit is a popular hub for discussing vaping. A deeper understanding of the factors that influence this online discourse could inform public health messaging efforts targeting this platform. Using a network analysis framework, we sought to investigate the role of opinion leaders and online communities in facilitating vaping discussions on Reddit. We collected Reddit submissions about vaping posted in May 2021 and used these submissions to generate subreddit-level (N=261) and thread-level (N=8,377) data sets. We coded subreddits into four community categories: 1) Vaping, 2) Substance use, 3) Cessation, and 4) Non-specific. We used sociometric in-degree centrality statistics to identify subreddit opinion leaders. We computed non-parametric ANOVAs and negative binomial regressions to test associations between opinion leadership and subreddit community category variables on subreddit network composition (comprised of subreddit-level network nodes and edges) and the number of commenters on Reddit threads about vaping (thread-level). Subreddit network composition was largely dependent on opinion leaders in Non-specific communities, and less so in Vaping and Substance use communities. At the thread-level, the rate of commenters was higher among threads initiated by opinion leaders than non-opinion leaders (adjusted rate ratio [aRR]=4.84). Furthermore, threads posted in Vaping (aRR=1.64), Substance use (aRR=1.92), and Cessation (aRR=1.21) communities had higher commenter rates than those posted in Non-specific communities. Communities and opinion leaders play a key role in the composition and reach of vaping discussions on Reddit. These findings provide a foundation for public health campaigns and interventions targeting Reddit and perhaps other social media platforms. [ABSTRACT FROM AUTHOR]

Background: Mobile health technologies can be useful for providing disease self-management information and support to people with inflammatory bowel disease (IBD). Objective: The aim of this study was to test a self-management SMS text messaging intervention for people with IBD. Our goal was to examine intervention feasibility, acceptability, and engagement and to preliminarily evaluate improvements in certain self-reported health outcomes among participants. Methods: We developed an SMS text messaging program called Text4IBD. The program sent daily support messages and resources about disease self-management over the course of a 2-week, single-group, pretest-posttest intervention to participants (N=114) diagnosed with IBD. We examined intervention feasibility, acceptability, and engagement through Text4IBD message topic recall and use of resources (ie, visiting supplemental websites recommended by the Text4IBD program). We also assessed pretest-posttest measures of IBD-related distress, self-efficacy, perceived support, use of coping strategies, and medication adherence. Analyses examined participants’ evaluations of the intervention and compared pretest-posttest changes in secondary outcomes using paired-samples statistics. Results: Approximately all participants who completed the intervention (n=105) were receptive to Text4IBD and viewed the program as feasible and acceptable. In addition, most participants (103/105, 98.1%) recalled at least one of the message topics sent by the program, and 79% (83/105) of them self-reported engaging with at least one of the external self-management resources recommended by the Text4IBD program. Pretest-posttest results showed reduced IBD-related distress (mean 3.33, SD 0.68 vs mean 2.86, SD 0.73; P<.001) and improvements in most other secondary outcomes. Conclusions: Findings from this study highlight the value of SMS text messaging as a useful digital medium for providing support to people with IBD, particularly to those who may struggle with disease-related distress. Text4IBD was highly feasible and acceptable and may help people self-manage their IBD. Future studies should aim to evaluate this program in a randomized controlled trial in clinical settings. [ABSTRACT FROM AUTHOR]

Perceived message effectiveness (PME) is commonly used in health communication research and practice, yet there has been a dearth of studies comparing different operationalizations of the PME construct. In the present study, we compared the two major types of PME – message perceptions and effects perceptions – among N = 557 young adults. Participants were randomized to one of two conditions: 1) The Real Cost e-cigarette prevention ads developed by the Food and Drug Administration (FDA condition) or 2) information-only e-cigarette control ads developed by the Mayo Clinic (control ad condition). Study predictors were message and effects perceptions measures and actual message effectiveness (AME) outcomes were risk beliefs about vaping and intentions to vape. Results showed that both message perceptions (M = 3.82 vs M = 3.29; p <.001) and effects perceptions (M = 4.13 vs M = 3.82; p <.001) were higher in the FDA ad condition compared to control. Risk beliefs about vaping were also higher in the FDA ad condition than control (M = 3.95 vs M = 3.79; p =.022), but we found no differences in participants' intentions to vape, which were low overall (M = 1.59 in FDA vs M = 1.58 in control). In multivariate analyses adjusting for covariates and including both types of PME, only effects perceptions (not message perceptions) were associated with risk beliefs about vaping (b =.37, p <.001) and intentions to vape (b = −.26, p <.001). Our findings advance PME research by demonstrating the differing nature of message and effects perceptions, and suggest that effects perceptions should be utilized during message pretesting. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) illness interventions are increasingly utilizing eHealth technologies, yet little is currently known about the extent of their impact on patient outcomes. The purpose of this study was to conduct a meta-analysis of the GI eHealth intervention literature. We used a comprehensive search strategy to locate studies. To be included, studies had to be a randomized controlled trial comparing an eHealth intervention condition against a no-treatment or waitlist control condition. Studies had to report data on at least one of the following patient outcomes: medication adherence, quality of life (QoL), psychological distress, illness-related knowledge, or number of patient visits to the clinic/hospital. Analyses weighted effect sizes (d) by their inverse variance and combined them using random effects meta-analytic procedures. K = 19 studies conducted in eight countries with a cumulative sample size of N = 3,193 were meta-analyzed. Findings indicated that GI eHealth interventions improved patients' QoL (d =.25, p =.008), psychological distress (d =.24, p =.017), medication adherence (d =.17, p =.014), and illness-related knowledge (d =.19, p =.002). GI eHealth interventions also significantly reduced the number of patient visits to the clinic/hospital (d =.78, p =.005). Our findings suggest that eHealth interventions hold promise in improving patient outcomes for those with GI illnesses. We suggest the next generation of GI interventions continue developing and evaluating the impact of technology using randomized controlled trial designs, and perhaps consider adapting existing efficacious interventions for burgeoning platforms, such as smartphones and tablets. [ABSTRACT FROM AUTHOR]

Introduction: Evidence for the health harms of e-cigarettes is growing, yet little is known about which harms may be most impactful in health messaging. Our study sought to identify which harms tobacco product users were aware of and which most discouraged them from wanting to vape.Methods: Participants were a convenience sample of 1,872 U.S. adult e-cigarette-only users, cigarette-only smokers, and dual users recruited in August 2018. In an online survey, participants evaluated 40 e-cigarette harms from seven categories: chemical exposures, device explosions, addiction, cardiovascular harm, respiratory harm, e-liquid toxicity, and other harms. Outcomes were awareness of the harms ("check all that apply") and the extent to which the harms discouraged vaping (5-point scale; (1) "not at all" to (5) "very much").Results: Awareness of most e-cigarette harms was modest, being highest for harms in the device explosions category of harms (44%) and lowest for the e-liquid toxicity category (16%). The harms with the highest mean discouragement from wanting to vape were the respiratory harm (M = 3.82) and exposure to chemicals (M = 3.68) categories. Harms in the addiction category were the least discouraging (M = 2.83) compared with other harms (all p < .001). Findings were similar for e-cigarette-only users, cigarette-only smokers, and dual users.Conclusions: Addiction was the least motivating e-cigarette harm, a notable finding given that the current FDA e-cigarette health warning communicates only about nicotine addiction. The next generation of e-cigarette health warnings and communication campaigns should highlight other harms, especially respiratory harms and the chemical exposures that may lead to health consequences.Implications: E-cigarette health harms related to respiratory effects, chemical exposures, and other health areas most discouraged vaping among tobacco users. In contrast, health harms about addiction least discouraged use. Several countries have begun implementing e-cigarette health warnings, including the United States, and many others are considering adopting similar policies. To increase impact, future warnings and other health communication efforts should communicate about health harms beyond addiction, such as the effects of e-cigarette use on respiratory health. Such efforts should communicate that e-cigarette use is risky and may pose less overall risk to human health than smoking, according to current evidence. [ABSTRACT FROM AUTHOR]

This study examined the echo chamber phenomenon and opinion leadership on Twitter based on the 2016 U.S. presidential election. Network analysis and 'big data' analytics were employed to analyze more than 50 million tweets about the two presidential candidates, Donald Trump and Hillary Clinton, during the election cycle. Overall, the results suggested that Twitter communities discussing Trump and Clinton differed significantly in the level of political homogeneity and opinion leadership, and that certain opinion leaders were responsible of creating homogeneous communities on Twitter. This study made a theoretical contribution to the literature by linking opinion leadership and Twitter's network structure and shedding light on what may have caused the echo chamber problem to happen in an emerging media landscape. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is a serious chronic illness that affects 1 in 200 people in the United States with the majority of new cases of IBD diagnosed in young people under the age of 35. Despite the growing number of people who are diagnosed each year, the consequences of health-related stigma faced by young people grappling with the effects of IBD are understudied. This experimental investigation explored the existence of enacted stigma among college students, a population that faces many social and psychological challenges due to the added emotional stresses brought about by the transition from high school and adolescence to college and adulthood. Results indicate that enacted stigma among college students toward other students with IBD decreases when disclosure of the disease is present. Results also suggest that greater knowledge of the nature and symptoms of IBD positively correlates to decreased stigma. [ABSTRACT FROM AUTHOR]

The U.S. Food and Drug Administration (FDA) developed a public education campaign, The Real Cost , that reduced youth susceptibility to tobacco product use. We sought to identify the mechanisms that may underlie the impact of The Real Cost ads on susceptibility to vaping to inform youth tobacco prevention campaigns. Our online randomized controlled trial (clinicaltrials.gov, identifier NCT04836455) examined a large sample of U.S. adolescents ( n = 1,348) who had multiple exposures to Real Cost ads or control videos over a 3-week period in 2021. To examine potential mediating pathways between The Real Cos t ads and susceptibility to vaping, we examined theory-based psychosocial and message-related variables. The largest impact of The Real Cost ads on susceptibility was via more negative attitudes toward vaping (β a *β b = -0.16; 95% confidence interval [CI] = [-0.25, -0.06]). Other mediation paths were via improved health harm risk beliefs (β a *β b = -0.08; 95% CI = [-0.13, -0.04]), addiction risk beliefs (β a *β b = -0.04; 95% CI = [-0.06, -0.01]), injunctive norms against vaping (β a *β b = -0.05; 95% CI = [-0.09, -0.02]), negative affect (β a *β b = -0.05; 95% CI = [-0.08, -0.02]), and cognitive elaboration (β a = -0.03; 95% CI = [-0.05, -0.003]). Our findings suggest that ads that target negative attitudes may decrease susceptibility to vaping among youth. Our findings also introduce normative pressure as a novel factor that may be important for vaping prevention messages.b = -0.03; 95% CI = [-0.05, -0.003]). Our findings suggest that ads that target negative attitudes may decrease susceptibility to vaping among youth. Our findings also introduce normative pressure as a novel factor that may be important for vaping prevention messages., Competing Interests: Authors’ NoteHaijing Ma is also affiliated to College of Liberal Arts & Social Sciences, University of Houston-Victoria, Victoria, TX, USA. Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: S.M.N. has served as a paid expert witness in litigation against tobacco and e-cigarette companies. J.A.R. has served as a paid expert consultant in litigation against tobacco companies. The other authors declared no conflicts of interest.

Introduction: Reddit is a popular social media platform for sharing information about vaping. Little is known about the types of external resources that Reddit users in vaping communities share and engage with., Methods: We analysed 2315 posts containing uniform resource locators (URLs) published to vaping communities on Reddit between November 2021 and October 2022. We coded URLs into eight mutually exclusive domain types. A mixed-effects Poisson regression model examined whether domain type was associated with user engagement (ie, number of unique commenters)., Results: Posts contained links to social media (35%), image hosting (31%), vaping-related commerce (19%), eJuice (12%), general vaping (6%), news (2%) and research (1%) URL domains. There were 237 unique vaping-related commerce domains (eg, ziipstock.com). The average number of commenters per post was 5.43 (SD=8.04). The rate of commenters was higher for posts sharing research (adjusted rate ratio (aRR) 1.74, 95% CI 1.28 to 2.36) and news (aRR 1.56, 95% CI 1.02 to 2.38) domains compared with vape-related commerce domains., Conclusion: Reddit users in vaping communities share and interact with a variety of external resources. The >200 different vaping-related commerce domains in our sample speak to the breadth and availability of websites that Reddit users (perhaps even those underage) may be using to browse and purchase vaping devices., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)