Vaping advocates promote false claims on Twitter about COVID-19 and e-cigarettes

Vaping advocates on Twitter promoted false claims about the ability of tobacco, nicotine, or vaping to treat or prevent COVID-19 through retweets, based on new Truth Initiative research published in the Journal of Medical Internet Research. The study finds that the majority (50%-88%) of the most active Twitter users discussing COVID-19 and nicotine or tobacco products had pro-vaping perspectives, and that tweets supporting the idea that nicotine had a protective effect against COVID-19 were circulated 20X more often than those that debunked the claims. Vaping advocates played a key role in amplifying and re-tweeting misleading content about tobacco, nicotine, and COVID-19 on Twitter, underscoring the challenges of mitigating the role a small group of users with pro-vaping perspectives can play in undermining effective public health messaging.

Misinformation spreads quickly on social media

Social media platforms – rampant ground for the spread of misinformation – played an important role in spreading the idea that nicotine protects against COVID-19. The authors of one early study that found smokers were less likely to be admitted for intensive care due to COVID-19 speculated that nicotine’s anti-inflammatory properties may have been responsible for the link. Although there was no subsequent evidence for this relationship – but there is conclusive evidence that smoking weakens the immune system and increases the risk of infectious diseases and respiratory infections – the claims nevertheless spread like wildfire on social media.

Misinformation about nicotine and COVID-19 can have serious consequences: recall and belief in misinformation about nicotine and COVID-19 are associated with relapse among e-cigarette users, according to a separate Truth Initiative study published in Health Education & Behavior. A third Truth Initiative study found that many young adults aren’t aware of the dangers of nicotine and that the spread of misleading claims about nicotine, especially regarding COVID-19, is tied to holding more positive beliefs about the tobacco industry.

The prevalence of pro-vaping perspectives

Truth Initiative researchers identified more than 1 million tweets about vaping, nicotine, and tobacco that were posted within the first nine months of the pandemic and characterized the users most often posting and sharing this content.

Researchers found that between 50% and 88% of top users discussing COVID-19 and vaping on Twitter were vaping advocates, meaning their profile or username explicitly mentioned vaping or tobacco harm reduction, that they had pinned a tweet promoting vaping, or at least three out of five of their most recent tweets explicitly promoted vaping. Researchers also found that most posts (78%) were retweets, suggesting that a small group of users – many of whom are decidedly pro-vaping – have an outsize impact on spreading the misinformation shared by other users.

Viral spread of unsubstantiated claims about nicotine and COVID-19

Researchers also found that many of the posts (22.5%) associated with COVID-19 and nicotine revolved around the ability of nicotine, tobacco, or vaping to treat or prevent COVID-19. Within the top 1,000 tweets these claims were 20 times more common, and retweeted 17 times as often, compared to the mere five tweets aiming to debunk the claims. In addition, one third of shared URLs were for articles supporting a therapeutic application for nicotine and tobacco products.

Hashtags surrounding the topic ran the gamut from #vapefam and #wevapewevote to #vapingsaveslives. The ubiquity of these hashtags provides additional evidence of strong pro-vaping perspectives on Twitter around the discussion involving COVID-19 and vaping.

“In the context of nicotine’s potential role in preventing COVID-19, Twitter undoubtedly amplified bad information when good information was available,” the authors write. “The observable pro-vaping bias of the most outspoken users discussing COVID-19 and nicotine inevitably meant that even attempts to debunk such information on the platform did not receive nearly the same amount of traffic.”

“The broader implication of this process of dissemination is that the proverbial deck is stacked against effective public health communication on Twitter,” the authors conclude. Understanding how vaping advocates on social media can work to muddy the waters of information through social media gives a clearer picture of the obstacles public health messaging faces.