Abstract
INTRODUCTIONWhile debates on e-cigarettes are mainly conducted in scientific fora, media are the most accessible information source for the public, shaping their perceptions of health issues. This study is the first to examine e-cigarette related topics with conflicting arguments presented in Chinese newspapers.METHODSThe Chinese terms for ‘e-cigarettes’ were searched in a widely used Chinese news database Wisenews. Content analysis of the full text of 639 news articles was conducted to identify topics with conflicting arguments and examine whether the dominant argument in each topic changed across four time periods from 2004 to 2019.RESULTSTwelve e-cigarette related topics with conflicting arguments were identified. The most frequently reported topic was health impact of e-cigarettes, followed by impact of secondhand aerosol exposure, smoking cessation, relative health impact of e-cigarettes compared to cigarettes, and e-cigarette policies outside China. At the same time, the price was the least frequently reported topic. Overall, negative arguments outnumbered positive arguments in the study period. The dominant arguments within many topics changed across time periods; however, within the topics of relative health impact of e-cigarettes compared to cigarettes, taste/flavor, and economic prospects of the industry, positive arguments were more frequently reported in almost all periods. Within the topics of addiction, policies in China, and policies outside China, negative arguments were more frequently reported in virtually all periods.CONCLUSIONSThough overall the dominant argument about e-cigarettes and health was ‘e-cigarettes are harmful’, in the early time periods, e-cigarettes were reported as ‘harmless’ or even ‘healthy’. As China began to regulate e-cigarettes, the reporting on e-cigarettes more frequently included the ‘e-cigarettes are harmful’ argument. The consistent, more frequent reporting of ‘good e-cigarette taste/flavor’ has the potential to attract young people to e-cigarette products. The increased reporting on policies unfavorable to e-cigarettes aligned with the growing number of regulations restricting e-cigarettes.
Highlights
While debates on e-cigarettes are mainly conducted in scientific fora, media are the most accessible information source for the public, shaping their perceptions of health issues
Comparing the number of conflicting arguments within each topic in the whole study period of 2004–2019, it was observed that the arguments that were unfavorable to e-cigarettes or e-cigarette industry development were reported more frequently than arguments favorable to e-cigarettes or e-cigarette industry development within the topics of health impact of e-cigarettes, addiction, use safety, smoking cessation, policies in China, and policies outside China, while positive arguments were more reported than negative arguments within the topics of relative health impact compared to cigarettes, price, impact of secondhand aerosol exposure, taste/flavor, regulation effectiveness, and economic prospects of the industry
A pattern was observed within the topics of health impact of e-cigarettes, use safety, impact of secondhand aerosol exposure, and smoking cessation: the dominant arguments were the positive arguments in the first period, 2004–2006, but changed to the negative arguments starting in the second period, 2007–2010, or the third period, 2011–2017
Summary
While debates on e-cigarettes are mainly conducted in scientific fora, media are the most accessible information source for the public, shaping their perceptions of health issues. Electronic cigarettes (e-cigarettes), known by many different names such as ‘e-cigs’, ‘vapes’, and electronic nicotine delivery systems (ENDS) etc., are devices that produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and chemicals[1]. First appearing in the Chinese market in 2003, e-cigarettes have gained increasing popularity worldwide. E-cigarettes are the subject of debate in the public health field. While some studies found that e-cigarette use may worsen asthma, bronchitis, and cough, including among non-smoking young people[5,6], other studies found that after switching to e-cigarettes, smokers with asthma or chronic obstructive lung disease reported improved symptoms[7,8]
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