I wake up and hit the JUUL: Analyzing Twitter for JUUL nicotine effects and dependence

Jaime E Sidani; Jason B Colditz; Erica L Barrett; Ariel Shensa; Kar-Hai Chu; A Everette James; Brian A Primack

doi:10.1016/j.drugalcdep.2019.06.005

I wake up and hit the JUUL: Analyzing Twitter for JUUL nicotine effects and dependence

Drug Alcohol Depend. 2019 Nov 1:204:107500. doi: 10.1016/j.drugalcdep.2019.06.005. Epub 2019 Aug 30.

Authors

Jaime E Sidani¹, Jason B Colditz², Erica L Barrett², Ariel Shensa², Kar-Hai Chu², A Everette James³, Brian A Primack⁴

Affiliations

¹ Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States. Electronic address: Jaime.sidani@pitt.edu.
² Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States.
³ Health Policy Institute, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, United States.
⁴ College of Education and Health Professions, University of Arkansas, 324 Graduate Education Building, Fayetteville, AR, 72701, United States.

Abstract

Background: JUUL-a novel electronic nicotine delivery system (ENDS)-comprises most of the ENDS market share. Additionally, JUUL has a high nicotine content and utilizes a patented nicotine salt formulation aimed to speed absorption. Many JUUL users are not aware of the nicotine content and therefore may not be expecting acute nicotine effects or potential for dependence. This study sought to analyze Twitter messages ("tweets") regarding nicotine, symptoms of dependence, and withdrawal related to JUUL use.

Methods: Data were collected from Twitter's Filtered Streams interface 4/11-6/16/2018 by retrieving tweets matching the terms "juul," "juuls," and "juuling" that also used words consistent with nicotine effects, symptoms of dependence, and withdrawal. A random 5% subsample (n = 1986) was coded by 2 independent coders. Cohen's κ for inter-rater reliability ranged 0.62-1.00 for all coded variables. Tweets were assessed using a qualitative content analysis approach.

Results: A total of 335 tweets mentioned dependence-related themes, including use upon waking and compulsion to use. A total of 189 tweets mentioned themes related to nicotine, with almost 15% of these tweets describing physical effects. Additionally, 42 tweets mentioned themes related to quitting JUUL and/or withdrawal from JUUL.

Discussion: This qualitative analysis suggests that users of JUUL are experiencing symptoms of nicotine exposure and dependence. Considering the high nicotine content of JUUL and the rising popularity among young people, more research around initiation of and dependence on JUUL, as well as the impact of recent FDA policy changes, should be conducted.

Keywords: Dependence; JUUL; Nicotine; Twitter; Withdrawal.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Data Collection
Electronic Nicotine Delivery Systems / statistics & numerical data*
Humans
Nicotine / adverse effects*
Qualitative Research
Reproducibility of Results
Social Media / statistics & numerical data*
Substance Withdrawal Syndrome / psychology*
Tobacco Use Disorder / psychology*

Substances

Nicotine

Grants and funding

R01 CA225773/CA/NCI NIH HHS/United States