The Association between Twitter Activity and E-cigarette Purchasing

Objectives: Industry, policymakers, researchers, and others have interest in social media, assuming that they influence – or reflect – individual behavior, despite limited supporting research. Electronic nicotine delivery systems (ENDS) emerged in the United States in the past decade alongside strong social media presence, making ENDS relevant for examining this issue. In this study, we examined monthly ENDS-related Twitter activity (tweet volume) in relation to monthly ENDS purchasing among ENDS purchasers. Methods: Data from 2105 Nielsen Consumer Panel households with any ENDS purchases from October 2012 to September 2015 were examined, accounting for ENDS advertising expenditures, state-level tobacco environment, and consumer characteristics. Results: ENDS-related purchases and twitter volume increased over time; advertising expenditures did not increase at the same level. Bivariate analyses indicated that ENDS purchases increased over time (p < .001) and were related to lower designated market area advertising expenditures (p = .025), higher cigarette taxes (p = .015), and older consumer age (p = .001). Among ENDS purchasers, multivariate analyses indicated that purchases correlated positively with tweet volume but negatively with advertising expenditure measures. Conclusions: Social media (eg, Twitter) may offer platforms for monitoring and/or intervening with respect to ENDS use, and potentially the ENDS industry, which engages in social media.