Abstract
To combat the e-cigarette epidemic among young audiences, a federal law was passed in the US that raised the minimum legal sales age of tobacco to 21 years (commonly known as Tobacco 21). Little is known about sentiment toward this law. Thus, the purpose of our study was to systematically explore trends about Tobacco 21 discussions and comparisons to other age-restriction behaviors on Twitter. Twitter data (n = 4628) were collected from September to December of 2019 that were related to Tobacco 21. A random subsample of identified tweets was used to develop a codebook. Two trained coders independently coded all data, with strong inter-rater reliability (κ = 0.71 to 0.93) found for all content categories. Associations between sentiment and content categories were calculated using χ2 analyses. Among relevant tweets (n = 955), the most common theme—the disjunction between ages for military enlistment and tobacco use—was found in 17.8% of all tweets. Anti-policy sentiment was strongly associated with the age of military enlistment, alcohol, voting, and adulthood (p < 0.001 for all). Opposition to Tobacco 21 propagates on social media because the US federal law does not exempt military members. However, the e-cigarette epidemic may have fueled some support for this law.
Highlights
Because the first Tobacco 21 bill presented to the US Senate was championed by Senator Mitch McConnell (Republican, Kentucky, Senate Majority Leader in 2019), his name appeared in news and social media posts about this topic and was included as a search term
Our findings highlight similar policy opposition identified by others, such as protests against a “nanny state” and suggestions that those who are willing to enlist in the military should be able to use tobacco products [30]
Such sentiment provides context to the political climate at the time the federal Tobacco 21 policy was passed, which was influenced by supportive “front groups” such as vape shop owners, employees, and advocacy organizations that were provided resources by the tobacco industry to appear as a “grassroots”
Summary
Between June 2019 and February 2020, the US faced an e-cigarette and vaping-related illnesses (EVALI) epidemic that caused 2807 hospitalizations and 68 deaths in the US, with. 52% of EVALI cases found among those less than 24 years of age [1]. This health crisis led members of the public health community to urge the government and governmental agencies (e.g., FDA) to pass meaningful policies to reduce youth and young adult access to and use of all tobacco products. On December 2019 the US federal government enacted “Tobacco 21”, which raised the minimum legal sales age (MLSA) of tobacco (which includes e-cigarettes) to years [2], a law that several other countries are considering [3].
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