Background: As the most popular video sharing website in the world, YouTube has the potential to reach and influence a huge audience. This study aims to gain a systematic understanding of what e-cigarette messages people are being exposed to on YouTube by assessing the quantity, portrayal and reach of e-cigarette videos.
Methods: Researchers identified the top 20 search results on YouTube by relevance and view count for the following search terms: "electronic cigarettes", "e-cigarettes", "ecigarettes", "ecigs", "smoking electronic cigarettes", "smoking e-cigarettes", "smoking ecigarettes", "smoking ecigs". A sample of 196 unique videos was coded for overall portrayal and genre. Main topics covered in e-cigarette videos were recorded and video statistics and viewer demographic information were documented.
Results: Among the 196 unique videos, 94% (n = 185) were "pro" to e-cigarettes and 4% (n = 8) were neutral, while there were only 2% (n = 3) that were "anti" to e-cigarettes. The top 3 most prevalent genres of videos were advertisement, user sharing and product review. 84.3% of "pro" videos contained Web links for e-cigarette purchase. 71.4% of "pro" videos claimed that e-cigarettes were healthier than conventional cigarettes. Audience was primarily from the United States, the United Kingdom and Canada and "pro" e-cigarette videos were watched more frequently and rated much more favorably than "anti" ones.
Conclusions: The vast majority of information on YouTube about e-cigarettes promoted their use and depicted the use of e-cigarettes as socially acceptable. It is critical to develop appropriate health campaigns to inform e-cigarette consumers of potential harms associated with e-cigarette use.