Live, Love, Juul: User and Content Analysis of Twitter Posts about Juul

Objectives: In this study, we identified patterns of communication around Juul use and users on Twitter.Methods: Public tweets were collected from April 27, 2018 until June 27, 2018. We categorized 1008 randomly selected tweets on 4 dimensions: user type, sentiment, genre, and theme. Results: Most tweets were through personal accounts followed by ones of the tobacco industry. Participation by anti-tobacco campaigners, educational, and governmental entities was limited. Posts were mostly about first-hand use, use intentions, and personal opinions. Tweets advocating Juul were most common; meanwhile a handful of tweets discouraged Juul use. Young women, young men, and the tobacco industry expressed positive sentiments about Juul. Conclusions: Twitter data are a rich source of public communication to complement surveillance of emerging tobacco products. Youth actively and positively communicate about Juul on Twitter. Educational content and strategies must be examined for curtailing dissemination of positive sentiments and advocacy that normalize and promote Juul use among youth and non-smokers. We observed limited evidence supporting a claim for Juul to be a smoking cessation adjunct.