Relationship between social media engagement and e-cigarette policy support

Introduction: Given increasing efforts to regulate e-cigarettes, it is important to understand factors associated with support for tobacco regulatory policies. We investigate such factors found in social media and hypothesize that greater online engagement with tobacco content would be associated with less support for e-cigarette regulatory policies. Methods: We constructed social networks of Twitter users who tweet about tobacco and categorized them using a combination of social network and Twitter metrics. Twitter users were identified as representing leaders, followers or general users in online discussions of tobacco products, and invited to complete an online survey. Participants responded to questions about their engagement with tobacco-related content online, degree of support for e-cigarette regulations, exposure to tobacco marketing, e-cigarette use and other demographic information. We examined links between their reported engagement with tobacco-related content and support for e-cigarette regulatory policies using structural equation modelling. Results: The analytic sample consisted of 470 participants. The conceptualized structural equation model had a good fit (χ2 (32) = 24.85, p = 0.09, CFI = 0.99, RMSEA = 0.03). Findings support our hypothesis: engagement with online tobacco content was negatively associated with support for e-cigarette policies, while controlling for e-cigarette use, tobacco marketing exposure, social media use frequency and demographic factors. Conclusions: Findings suggest that our hypothesis was supported. Twitter users engaging with tobacco-related content and harboring negative attitudes toward e-cigarette regulatory policies could be an important audience segment to reach with tailored e-cigarette policy education messages. Keywords: E-cigarettes, Tobacco policy, Engagement, Social medi