This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
The US Food and Drug Administration (FDA) recently restricted characterizing flavors in tobacco products. As a result, ice hybrid–flavored e-cigarettes, which combine a cooling flavor with fruit or other flavors (eg, banana ice), emerged on the market. Like menthol, ice-flavored e-cigarettes produce a cooling sensory experience. It is unclear if ice hybrid–flavored e-cigarettes should be considered characterizing flavors or menthol, limiting regulatory action. Monitoring the public’s conversations about ice-flavored e-cigarettes on Twitter may help inform the tobacco control community about these products and contribute to the US FDA policy targets in the future.
This study documented the themes pertaining to vaping and ice flavor–related conversations on Twitter. Our goal was to identify key conversation trends and ascertain users’ recent experiences with ice-flavored e-cigarette products.
Posts containing vaping-related (eg, “vape,” “ecig,” “e-juice,” or “e-cigarette”) and ice-related (ie, “Ice,” “Cool,” “Frost,” and “Arctic”) terms were collected from Twitter’s streaming application programming interface from January 1 to July 21, 2021. After removing retweets, a random sample of posts (N=2001) was selected, with 590 posts included in the content analysis. Themes were developed through an inductive approach. Theme co-occurrence was also examined.
Many of the 590 posts were marked as (or consisted of) marketing material (n=306, 51.9%), contained positive personal testimonials (n=180, 30.5%), and mentioned disposable pods (n=117, 19.8%). Other themes had relatively low prevalence in the sample: neutral personal testimonials (n=45, 7.6%), cannabidiol products (n=41, 7%), negative personal testimonials (n=41, 7%), “official” flavor description (n=37, 6.3%), ice-flavored JUUL (n=19, 3.2%), information seeking (n=14, 2.4%), and comparison to combustible tobacco (n=10, 1.7%). The most common co-occurring themes in a single tweet were related to marketing and disposable pods (n=73, 12.4%).
Our findings offer insight into the public’s experience with and understanding of ice-flavored e-cigarette products. Ice-flavored e-cigarette products are actively marketed on Twitter, and the messages about them are positive. Public health education campaigns on the harms of flavored e-cigarettes may help to reduce positive social norms about ice-flavored products. Future studies should evaluate the relationship between exposure to personal testimonials of ice-flavored vaping products and curiosity, harm perceptions, and experimentation with these products among priority populations.
The use of e-cigarettes, or vaping, among adolescents and young adults is a public health concern [
Ice hybrid–flavored products may contain menthol. Menthol is a flavor additive that produces pleasant cooling sensations and analgesic effects in the throat and mouth, which reduces the harshness of combustible smoke and nicotine’s irritating effects on the airways [
One approach that may be helpful in informing regulatory efforts is the tracking and analyzing of real-world conversations and depictions of novel tobacco products on Twitter [
This study used Twitter data to document the themes in posts pertaining to ice flavors. Examining and monitoring the public’s conversations about ice-flavored e-cigarettes may help inform the tobacco control community about these products and uncover trends, knowledge, and attitudes toward e-cigarette flavors. Findings from this study may contribute to the US FDA policy targets and tobacco control campaigns in the future.
Twitter posts containing both vaping-related (eg, “vape,” “ecig,” “e-juice,” “e-cigarette,” or “JUUL”; see
Vaping-related posts that contained the terms “Ice,” “Cool,” “Frost,” or “Arctic” but were determined to be unrelated to our research objectives were identified through manual content analysis and removed. For instance, irrelevant posts contained the following phrases: “cool vape trick” and “vaping is cool.” After excluding irrelevant and non-English posts, we were left with 590 (29.5%) tweets that were included in the content analysis.
The codebook consists of the following themes:
Descriptive analyses were conducted first to show the prevalence of each theme. Further, pairwise co-occurrence analyses were used to evaluate connections across themes, since tweets often included more than one theme. R base package (version 4.0.2; R Foundation for Statistical Computing) was used to construct the co-occurrence matrix, and the igraph package (version 1.2.6) was used to visualize the results. Since the theme related to
All Twitter posts in this data set were publicly available and anonymized, and all analyses adhered to the terms and conditions, terms of use, and privacy policies of Twitter. To further protect privacy, posts exemplifying themes were paraphrased; no tweets are reported verbatim.
Co-occurrences of themes in corpus tweets. The size of the circles represents the frequency of the theme occurrences. The proximity of the circles and the size of the lines represent the frequency of the theme pairwise co-occurrences. CBD: cannabidiol.
The protocol was approved by the university’s institutional review board (protocol HS-18-00697).
Descriptive characteristics of the 590 tweets from this corpus and example paraphrased posts are presented in
The most commonly co-occurring themes in a single tweet were related to the most prominent themes in the data set:
Definition for each theme, descriptive statistics, and selected paraphrased twitter posts.
Theme | Posts (n=590), n (%) | Definition | Paraphrased post |
Positive sentiment testimonials | 180 (30.5) | Posts containing a positive experience with (eg, tastes, smells great) or favorable opinion about (eg, love, like, my favorite) “ice-flavored” tobacco products, including e-liquids | “Lychee Ice is the best e-cigarette flavor” |
Negative sentiment testimonials | 41 (7.0) | Posts containing a negative experience with (eg, tastes, smells horrible, bad) or negative opinion about (eg, hate, dislike) “ice-flavored” tobacco products, including e-liquids | “Recently bought a banana ice vape and it tastes horrible...” |
Neutral sentiment testimonials | 45 (7.6) | Posts containing a neutral opinion about “ice-flavored” tobacco products, including e-liquids (eg, if no valence is determinable or deemed neutral) | “This tangerine-apple ice e-cigarette tastes like 7-up” |
Information seeking | 14 (2.4) | Posts where a consumer or potential consumer asks for information on or opinions about “ice-flavored” tobacco products, including e-liquids | “Do you guys know if a mango ice e-liquid tastes good?” |
Comparison to combustible tobacco | 10 (1.7) | Posts containing mentions of or comparisons between “ice-flavored” products, including e-liquids and combustible tobacco products | “...I am not planning to switch from my menthol cigarettes to vaping, but I will definitely buy one of these lychee ice flavored disposables...” |
Marketing | 306 (51.9) | Posts promoting/selling/marketing an “ice-flavored” e-liquids or devices | “Guava ice e-liquid is now available at https://xxx...” |
Disposable pod devices | 117 (19.8) | Mentions of “ice-flavored” disposable pod devices (ie, Puff Bar) | “Banana Ice Puff Bar is worth every penny...” |
JUUL | 19 (3.2) | Mentions of “ice-flavored” JUUL | “@xxx Ice flavored JUUL is the best JUUL” |
CBDa products | 41 (7.0) | Mentions of “ice-flavored” CBD vaping products | “New CBD Blackcurrant Ice Disposable vapes are now in stock at https://xxx...” |
Official flavor description | 37 (6.3) | Posts containing an official (ie, “media,” promotional, marketing) description of “ice-flavored” e-liquids or products | “...The sweet juice of Fuji apples combined with a hint of nectarines & strawberry to create a well rounded fruity vape experience with a cool refreshing finish...” |
Other | 6 (1.0) | Any other posts that contain ice flavor–related themes and do not fit into any category listed in the codebook | “Use of ice-flavored e-cigarettes may be associated with nicotine dependence. See https://xxx...” |
aCBD: cannabidiol.
This study provides a summary of public Twitter posts collected over the course of a 7-month period, which includes mentions of both vaping-related and ice flavor–related terms. Posts in our corpus were related to ice-flavored e-cigarette product marketing, personal testimonials, and ice-flavored disposable pod devices. Theme co-occurrence in a single post was examined.
Marketing was a common theme in this study, while marketing and disposable pod devices represented a common theme co-occurrence in a single post. These findings are consistent with recent studies suggesting that ice-flavored products are often promoted in various pod-style cartridge-based disposable (eg, Puff Bar) and refillable (eg, PUFF Krush, PHIX) e-cigarette products [
This study was limited to the analysis of discussions on ice-flavored e-cigarette products and may not pertain to other e-cigarette flavors. In addition, relatively few (n=2001, 0.2%) tweets among all identified ice tweets were analyzed (n=976,347), which limits the generalizability of our results. Moreover, the word “cool” was one of the four terms used to identify ice-flavored e-cigarette posts. “Cool” is a colloquialism and is commonly used to express the enjoyment of someone or something. The inclusion of this search term resulted in a collection of many posts that were unrelated to e-cigarette flavors; nonetheless, we found this limitation unavoidable and worked diligently to analyze pertinent tweets. This study focused on the text of the Twitter posts but did not code website links or accompanying images. Previous studies demonstrated that there is value in examining both text and image. In other words, it is possible that additional themes would have emerged had we coded images. Findings may not generalize to other time periods or other social media platforms. Our findings may not extend to all Twitter users or to the population of the United States.
Our findings may offer valuable insights into the public’s experience with and understanding of ice-flavored e-cigarette products. In this study, we found that Twitter discussions about ice-flavored e-cigarette products focused on marketing, personal testimonials, and ice-flavored disposable pod devices. Future studies should evaluate the relationship between exposure to personal testimonials of ice-flavored vaping products and curiosity, harm perceptions, and experimentation with these products among priority populations. Public health education campaigns informing the public on the harms of flavored e-cigarettes may be helpful in reducing positive social norms about ice-flavored products, while flavor regulatory actions may include ice flavors to prevent new products from circumventing current regulations. For instance, banning tobacco marketing posts on Twitter may reduce the exposure to ice-flavored e-cigarette product promotions. In addition, social media might be more influential than traditional marketing because participants can be actively engaged in the content they are viewing [
List of keywords.
cannabidiol
Food and Drug Administration
The research reported in this publication was supported by a National Cancer Institute (NCI) and Food and Drug Administration (FDA) Center for Tobacco Products award (NCI/FDA grant U54CA180905, Mary Ann Pentz and Adam Leventhal, principal investigators).
The NCI or the FDA had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
The data sets generated or analyzed during this study are available from the corresponding author on reasonable request.
All authors took an active role in the manuscript. AG, J-PA, and JBU conceptualized and designed the study. AG, J-PA, JBU, and JV created the codebook for data analysis. AG and EG completed data coding. AG, J-PA, and JV acquired, analyzed, and interpreted the data. AG, EG, and JV drafted the initial manuscript. AG, JV, EG, JBU, MGK, and J-PA revised the manuscript for important intellectual content. JBU and J-PA obtained funding for this study. All authors approved the final manuscript submitted.
J-PA has received fees for consulting services in court cases pertaining to the content on social media platforms. He reports no other conflicts of interest. All other authors declare no competing interests.