Images of Little Cigars and Cigarillos on Instagram Identified by the Hashtag #swisher: Thematic Analysis.

Jon-Patrick Allem,Jennifer B Unger,Patricia Escobedo,Kar-Hai Chu,Tess Boley Cruz

doi:10.2196/jmir.7634

Abstract

BackgroundLittle cigar and cigarillo use is becoming more prevalent in the United States and elsewhere, with implications for public health. As little cigar and cigarillo use grows in popularity, big social media data (eg, Instagram, Google Web Search, Twitter) can be used to capture and document the context in which individuals use, and are marketed, these tobacco products. Big social media data may allow people to organically demonstrate how and why they use little cigars and cigarillos, unprimed by a researcher, without instrument bias and at low costs.ObjectiveThis study characterized Swisher (the most popular brand of cigars in the United States, controlling over 75% of the market share) little cigar- and cigarillo-related posts on Instagram to inform the design of tobacco education campaigns and the development of future tobacco control efforts, and to demonstrate the utility in using big social media data in understanding health behaviors.MethodsWe collected images from Instagram, an image-based social media app allowing users to capture, customize, and post photos on the Internet with over 400 million active users. Inclusion criteria for this study consisted of an Instagram post with the hashtag “#swisher”. We established rules for coding themes of images.ResultsOf 1967 images collected, 486 (24.71%) were marijuana related, 348 (17.69%) were of tobacco products or promotional material, 324 (16.47%) showed individuals smoking, 225 (11.44%) were memes, and 584 (29.69%) were classified as other (eg, selfies, food, sexually explicit images). Of the marijuana-related images, 157/486 (32.3%) contained a Swisher wrapper, indicating that a Swisher product was used in blunt making, which involves hollowing out a cigar and refilling it with marijuana.ConclusionsImages from Instagram may be used to complement and extend the study of health behaviors including tobacco use. Images may be as valuable as, or more valuable than, words from other social media platforms alone. Posts on Instagram showing Swisher products, including blunt making, could add to the normalization of little cigar and cigarillo use and is an area of future research. Tobacco control researchers should design social media campaigns to combat smoking imagery found on popular sites such as Instagram.

Highlights

Cigarette smoking has declined, total consumption of cigars in the United States has increased dramatically since 1993, reversing a decline in consumption that had persisted for most of the twentieth century.[1]
The U.S Food and Drug Administration (FDA) stated that “Cigars are associated with significant risk and provide no public health benefit.”[3]
Male cigar smokers are up to eight times more likely than nonsmokers to die from oral cancer and ten times more likely to die from laryngeal cancers

Summary

Introduction

Cigarette smoking has declined, total consumption of cigars in the United States has increased dramatically since 1993, reversing a decline in consumption that had persisted for most of the twentieth century.[1]. For primary cigar smokers, higher smoking intensity (more cigars per day) and greater inhalation are associated with greater risks for oral, esophageal, laryngeal, and lung cancers.[13]

Results

Conclusion