The Volume and Tone of Twitter Posts About Cannabis Use During Pregnancy: A Scoping Review Protocol

Background: Cannabis use has increased in Canada since its legalization in 2018, includingamong pregnant women who may be motivated to use cannabis to reduce symptoms ofnausea and vomiting. However, a growing body of research suggests that cannabis useduring pregnancy may harm the developing fetus. As a result, patients increasingly seekmedical advice from online sources, but these platforms may also spread anecdotaldescriptions or misinformation. Given the possible disconnect between online messaging andevidence-based research about the effects of cannabis use during pregnancy, there is apotential for advice taken from social media to cause harm.Objectives: To quantify the volume and tone of English-language posts related to cannabisuse in pregnancy from January 2012 to July 2021.Methods: Modelling published frameworks for scoping reviews, we will collect publiclyavailable posts from Twitter that mention cannabis use during pregnancy and employ theTwitter Application Programming Interface (API) for Academic Research to extract data fromtweets, including public metrics such as the number of likes, retweets and quotes, as well ashealth effect mentions, sentiment, location and users interests. These data will be used toquantify how cannabis use during pregnancy is discussed on Twitter and to build a qualitativeprofile of supportive and opposing posters.Results: The CHEO Research Ethics Board reviewed our project and granted an exemptionin May 2021. As of September 2021, we have gained approval to use the Twitter API forAcademic Research and have developed a preliminary search strategy that returns over 2million unique tweets posted between 2012 and 2020.Conclusions: Understanding how Twitter is being used to discuss cannabis use duringpregnancy will help public health agencies and healthcare providers assess the messagingpatients may be receiving and develop communication strategies to counter misinformation,especially in geographical regions where legalization is recent or imminent. Most importantly,we foresee that our findings will assist expecting families in making informed choices aboutwhere they choose to access advice about using cannabis during pregnancy.