{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:52:32Z","timestamp":1781275952757,"version":"3.54.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Truth Initiative"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Twitter enables public organizations to engage the public in health policy discourse. However, documented hostility towards tobacco control proposals on Twitter suggests that a closer examination of the nature of interaction with such content is warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and Methods<\/jats:title><jats:p>We scraped tweets from government bodies with tobacco control interests between July and November of 2021 (N\u2005=\u20053889), 2 months before and after the Food and Drug Administration\u2019s (FDA) Premarket Tobacco Authorization Act\u2019s (PMTA) September deadline. PMTA is a review process for authorizing the sale of new and existing e-cigarette or vaping products. Tweets related to PMTA were identified (n\u2005=\u200552) using a keyword filter. A content analysis of quote tweets and replies examined the amplification of pro and anti-policy sentiment via likes and retweets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Replies were overwhelmingly anti-policy (96.7%). Moreover, the amplification of these replies, including 83.3% of likes and 65.6% of retweets, amplified anti-policy replies. Quote tweets, which allow users to add their own commentary to an existing tweet, were 77.9% (n\u2005=\u2005120) anti-policy, receiving 87.7% of likes (n\u2005=\u20051708) and 86.2% of retweets (n\u2005=\u2005726) compared to pro-policy quote tweets (n\u2005=\u2005240 likes and n\u2005=\u2005116 retweets). Regression analyses showed a significantly greater amplification of anti-policy content.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Communicating about tobacco policy on Twitter carries risks. Anti-policy advocates can weaponize quote tweets for easy construction of messages designed in accordance with evidence-based guidelines for conferring resistance to persuasion. Future research should examine whether public health organizations can adapt this strategy to counter anti-regulatory advocates on Twitter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>The primary implications of this research are that communication about tobacco policy on Twitter should be part of a broader public engagement strategy with quantifiable metrics of success. The information environment on Twitter is demonstrably hostile to pro-tobacco regulatory policy positions. As a result, efforts to engage on the platform by regulatory institutions like the FDA can inadvertently provide materials that are easily leveraged as effective counter-messaging. Moreover, this counter-messaging can disseminate more broadly than the original message.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ntr\/ntad078","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T19:41:11Z","timestamp":1684611671000},"page":"1603-1609","source":"Crossref","is-referenced-by-count":7,"title":["To Tweet or Not to Tweet: Tweets About Tobacco Regulation can Help Disseminate Anti-regulatory Messages"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0325-2559","authenticated-orcid":false,"given":"Nathan A","family":"Silver","sequence":"first","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Pearson","sequence":"additional","affiliation":[{"name":"Schroeder Institute, University of Pennsylvania , Philadelphia, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7278-9608","authenticated-orcid":false,"given":"Padmini","family":"Kucherlapaty","sequence":"additional","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swetha","family":"Kalla","sequence":"additional","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-2996","authenticated-orcid":false,"given":"Barbara","family":"Schillo","sequence":"additional","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"2023081908294110500_CIT0001","first-page":"200","article-title":"Quote RTs on Twitter: Usage of the new feature for political discourse","author":"Garimella","year":"2016"},{"issue":"11","key":"2023081908294110500_CIT0002","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1001\/jamapediatrics.2021.2432","article-title":"Collaborative public health strategies to combat e-cigarette regulation Loopholes","volume":"175","author":"Chu","year":"2021","journal-title":"JAMA Pediatr"},{"issue":"8","key":"2023081908294110500_CIT0003","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1093\/ntr\/ntaa276","article-title":"# FlavorsSaveLives: An analysis of Twitter posts opposing flavored e-cigarette bans","volume":"23","author":"Kirkpatrick","year":"2021","journal-title":"Nicotine Tob Res."},{"issue":"1","key":"2023081908294110500_CIT0004","doi-asserted-by":"crossref","first-page":"e24562e24562","DOI":"10.2196\/24562","article-title":"How health care workers wield influence through Twitter hashtags: retrospective cross-sectional study of the gun violence and COVID-19 public health crises","volume":"7","author":"Ojo","year":"2021","journal-title":"JMIR Public Health Surveill"},{"issue":"11","key":"2023081908294110500_CIT0005","doi-asserted-by":"crossref","first-page":"3537","DOI":"10.1017\/S1368980021000938","article-title":"A mixed-method analysis of the# SugarTax debate on Twitter","volume":"24","author":"Bridge","year":"2021","journal-title":"Public Health Nutr."},{"issue":"10","key":"2023081908294110500_CIT0006","doi-asserted-by":"crossref","first-page":"e238e3622","DOI":"10.2196\/jmir.3622","article-title":"Tweeting for and against public health policy: response to the Chicago Department of Public Health\u2019s electronic cigarette Twitter campaign","volume":"16","author":"Harris","year":"2014","journal-title":"J Med Internet Res."},{"issue":"2","key":"2023081908294110500_CIT0007","doi-asserted-by":"crossref","first-page":"e31e31","DOI":"10.2196\/jmir.2972","article-title":"Are public health organizations tweeting to the choir? 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