Leading Topics in Twitter Discourse on JUUL and Puff Bar Products: Content Analysis.

BACKGROUND: In response to the recent government restrictions, flavored JUUL products, which are rechargeable closed-system electronic cigarettes (e-cigarettes), are no longer available for sale. However, disposable closed-system products such as the flavored Puff Bar e-cigarette continues to be available. If e-cigarette consumers simply switch between products during the current government restrictions limited to 1 type of product over another, then such restrictions would be less effective. A step forward in this line of research is to understand how the public discusses these products by examining discourse referencing both Puff Bar and JUUL in the same conversation. Twitter data provide ample opportunity to capture such early trends that could be used to help public health researchers stay abreast of the rapidly changing e-cigarette marketplace. OBJECTIVE: The goal of this study was to examine public discourse referencing both Puff Bar and JUUL products in the same conversation on Twitter. METHODS: We collected data from Twitter's streaming application programming interface between July 16, 2019, and August 29, 2020, which included both "Puff Bar" and "JUUL" (n=2632). We then used an inductive approach to become familiar with the data and generate a codebook to identify common themes. Saturation was determined to be reached with 10 themes. RESULTS: Posts often mentioned flavors, dual use, design features, youth use, health risks, switching 1 product for the other, price, confusion over the differences between products, longevity of the products, and nicotine concentration. CONCLUSIONS: On examining the public's conversations about Puff Bar and JUUL products on Twitter, having described themes in posts, this study aimed to help the tobacco control community stay informed about 2 popular e-cigarette products with different device features, which can be potentially substituted for one another. Future health communication campaigns may consider targeting the health consequences of using multiple e-cigarette products or dual use to reduce exposure to high levels of nicotine among younger populations.