{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:01:20Z","timestamp":1782842480072,"version":"3.54.5"},"reference-count":51,"publisher":"JMIR Publications Inc.","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n Examining public perception of tobacco products is critical for effective tobacco policy making and public education outreach. While the link between traditional tobacco products and lung cancer is well established, it is not known how the public perceives the association between electronic cigarettes (e-cigarettes) and lung cancer. In addition, it is unclear how members of the public interact with official messages during cancer campaigns on tobacco consumption and lung cancer.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n In this study, we aimed to analyze e-cigarette and smoking tweets in the context of lung cancer during National Cancer Prevention Month in 2018 and examine how e-cigarette and traditional tobacco product discussions relate to implementation of tobacco control policies across different states in the United States.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We mined tweets that contained the term \u201clung cancer\u201d on Twitter from February to March 2018. The data set contained 13,946 publicly available tweets that occurred during National Cancer Prevention Month (February 2018), and 10,153 tweets that occurred during March 2018. E-cigarette\u2013related and smoking-related tweets were retrieved, using topic modeling and geospatial analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Debates on harmfulness (454\/915, 49.7%), personal experiences (316\/915, 34.5%), and e-cigarette risks (145\/915, 15.8%) were the major themes of e-cigarette tweets related to lung cancer. Policy discussions (2251\/3870, 58.1%), smoking risks (843\/3870, 21.8%), and personal experiences (776\/3870, 20.1%) were the major themes of smoking tweets related to lung cancer. Geospatial analysis showed that discussion on e-cigarette risks was positively correlated with the number of state-level smoke-free policies enacted for e-cigarettes. In particular, the number of indoor and on campus smoke-free policies was related to the number of tweets on e-cigarette risks (smoke-free indoor, r49=0.33, P=.02; smoke-free campus, r49=0.32, P=.02). The total number of e-cigarette policies was also positively related to the number of tweets on e-cigarette risks (r49=0.32, P=.02). In contrast, the number of smoking policies was not significantly associated with any of the smoking themes in the lung cancer discourse (P>.13).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Though people recognized the importance of traditional tobacco control policies in reducing lung cancer incidences, their views on e-cigarette risks were divided, and discussions on the importance of e-cigarette policy control were missing from public discourse. Findings suggest the need for health organizations to continuously engage the public in discussions on the potential health risks of e-cigarettes and raise awareness of the insidious lobbying efforts from the tobacco industry.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/28042","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T10:45:35Z","timestamp":1640774735000},"page":"e28042","source":"Crossref","is-referenced-by-count":1,"title":["Examining Twitter Discourse on Electronic Cigarette and Tobacco Consumption During National Cancer Prevention Month in 2018: Topic Modeling and Geospatial Analysis"],"prefix":"10.2196","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-7435","authenticated-orcid":false,"given":"Jiahui","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0536-2898","authenticated-orcid":false,"given":"Edmund W J","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,12,29]]},"reference":[{"key":"ref1","unstructured":"Tobacco controlWorld Health Organization2021-12-13https:\/\/www.who.int\/tobacco\/control\/en\/"},{"key":"ref2","unstructured":"WHO report on the global tobacco epidemic, 2017: monitoring tobacco use and prevention policiesWorld Health Organization2021-12-13https:\/\/www.who.int\/publications\/i\/item\/9789241512824"},{"key":"ref3","unstructured":"Tobacco-related mortalityCenters for Disease Control and Prevention2021-12-13https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/health_effects\/tobacco_related_mortality\/index.htm"},{"key":"ref4","unstructured":"Current smoking among adults in 2018 (States)Centers for Disease Control and Prevention2021-12-13https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/adult_data\/cig_smoking\/index.htm#states"},{"key":"ref5","unstructured":"Surgeon general\u2019s advisory on e-cigarette use among youthCenters for Disease Control and Prevention2018122021-12-13https:\/\/www.cdc.gov\/tobacco\/basic_information\/e-cigarettes\/surgeon-general-advisory\/index.html"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2018-054824"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-786"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4645"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2016-053096"},{"key":"ref10","doi-asserted-by":"crossref","DOI":"10.17226\/24952","author":"Stratton, K","year":"2018","journal-title":"Public Health Consequences of E-cigarettes"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1832"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2016.03.019"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30415-1"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1718185115"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.00272.2015"},{"key":"ref16","unstructured":"Outbreak of lung injury associated with the use of e-cigarette, or vaping, productsCenters for Disease Control Prevention2021-12-13https:\/\/www.cdc.gov\/tobacco\/basic_information\/e-cigarettes\/severe-lung-disease.html"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-017-0650-1"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1521\/bumc.2014.78.3.243"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-014-9605-2"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.10.018"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2013-051122"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.2196\/13673"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.2196\/11953"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2324"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2018.1493057"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.18001\/trs.2.2.5"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4517"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1080\/15230406.2013.776210"},{"key":"ref29","unstructured":"National Cancer Prevention MonthAmerican Association for Cancer Research2021-12-13https:\/\/www.aacr.org\/patients-caregivers\/awareness-months\/national-cancer-prevention-month\/"},{"key":"ref30","unstructured":"Lung cancer risk factorsAmerican Cancer Society2021-12-13https:\/\/www.cancer.org\/cancer\/lung-cancer\/causes-risks-prevention\/risk-factors.html"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-13-508"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2017.1421730"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2016.1266716"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1080\/13669877.2012.761264"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4969"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.2196\/publichealth.8641"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7022"},{"key":"ref38","first-page":"993","volume":"3","author":"Blei, D","year":"2003","journal-title":"J Mach Learn Res"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v040.i13"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1109\/apsecw.2017.11"},{"key":"ref41","unstructured":"Tobacco use \u2013 legislationCenters for Disease Control and Prevention2021-12-13https:\/\/chronicdata.cdc.gov\/browse?category=Legislation"},{"key":"ref42","unstructured":"American cancer society position on electronic cigarettesAmerican Cancer Society2021-12-13https:\/\/www.cancer.org\/healthy\/stay-away-from-tobacco\/e-cigarettes-vaping\/e-cigarette-position-statement.html"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6745a5"},{"key":"ref44","unstructured":"Talking to youth and young adults to prevent e-cigarette useCenters for Disease Control and Prevention2021-12-13https:\/\/www.cdc.gov\/features\/ecigarettes-young-people\/index.html"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2019-055081"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(19)31718-0"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntw124"},{"key":"ref48","unstructured":"FeuerWAltria stock craters after $4.1 billion hit from Juul investment, blames growing legal riskCNBC2021-12-13https:\/\/www.cnbc.com\/2020\/01\/30\/altria-is-taking-a-4point1-billion-charge-on-its-investment-in-juul.html"},{"key":"ref49","unstructured":"Tobacco use in Washington 2019Truth Initiative2021-12-13https:\/\/truthinitiative.org\/research-resources\/smoking-region\/tobacco-use-washington-2019"},{"key":"ref50","unstructured":"Understanding youth vaping in HawaiiThe Hawaii Department of Health2021-12-13https:\/\/www.healthyhawaii.com\/tobacco-free\/vaping\/"},{"key":"ref51","unstructured":"Extinguishing the tobacco epidemic in HawaiiCenters for Disease Control and Prevention2021-12-13https:\/\/www.cdc.gov\/tobacco\/about\/osh\/state-fact-sheets\/hawaii\/index.html"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2021\/12\/e28042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:40:48Z","timestamp":1782841248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2021\/12\/e28042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,29]]},"references-count":51,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2196\/28042","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.28042","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,29]]}}}