Abstract
BackgroundThe popularity of JUUL (an e-cigarette brand) among youth has recently been reported in news media and academic papers, which has raised great public health concerns. Little research has been conducted on the age distribution, geographic distribution, approaches to buying JUUL, and flavor preferences pertaining to underage JUUL users.ObjectiveThe aim of this study was to analyze social media data related to demographics, methods of access, product characteristics, and use patterns of underage JUUL use.MethodsWe collected publicly available JUUL-related data from Reddit. We extracted and summarized the age, location, and flavor preference of subreddit UnderageJuul users. We also compared common and unique users between subreddit UnderageJuul and subreddit JUUL. The methods of purchasing JUULs were analyzed by manually examining the content of the Reddit threads.ResultsA total of 716 threads and 2935 comments were collected from the subreddit UnderageJuul before it was shut down. Most threads did not mention a specific age, but ages ranged from 13 years to greater than 21 years in those that did. Mango, mint, and cucumber were the most popular among the 7 flavors listed on JUUL’s official website, and 336 subreddit UnderageJuul threads mentioned 7 discreet approaches to circumvent relevant legal regulations to get JUUL products, the most common of which was purchasing JUUL from other Reddit users (n=181). Almost half of the UnderageJuul users (389/844, 46.1%) also participated in discussions on the main JUUL subreddit and sought information across multiple Reddit forums. Most (64/74, 86%) posters were from large metropolitan areas.ConclusionsThe subreddit UnderageJuul functioned as a forum to explore methods of obtaining JUUL and to discuss and recommend specific flavors before it was shut down. About half of those using UnderageJuul also used the more general JUUL subreddit, so a forum still exists where youths can attempt to share information on how to obtain JUUL and other products. Exploration of such social media data in real time for rapid public health surveillance could provide early warning for significant health risks before they become major public health threats.
Highlights
BackgroundJUUL, the most popular e-cigarette brand in the United States, currently holds 71% of the market share, according to data from Wells Fargo in July 2018 [1]
The subreddit UnderageJuul functioned as a forum to explore methods of obtaining JUUL and to discuss and recommend specific flavors before it was shut down
Substantial and growing evidence shows that e-cigarette use by youth and young adults increases the risk of ever using conventional cigarettes, according to a 2018 report by the National Academies of Sciences, Engineering, and Medicine [7]
Summary
BackgroundJUUL, the most popular e-cigarette brand in the United States, currently holds 71% of the market share, according to data from Wells Fargo in July 2018 [1]. The popularity of JUUL among youth has recently been reported in news media [4,5,6]. As social media has become an emerging channel for information diffusion, JUUL-related discussions on platforms such as Twitter and Reddit have experienced a sharp increase since 2015 [8,9]. This sharp increase in teen JUUL usage, and the potential health impacts, has raised great public health concerns. The popularity of JUUL (an e-cigarette brand) among youth has recently been reported in news media and academic papers, which has raised great public health concerns. Little research has been conducted on the age distribution, geographic distribution, approaches to buying JUUL, and flavor preferences pertaining to underage JUUL users
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