An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis.

BACKGROUND: A 2012 World Health Organization report recognizes betel nut use as an urgent public health threat faced by the Western Pacific region. However, compared with other addictive substances, little is known about how betel nuts are depicted on social media platforms. In particular, image-based social media platforms can be powerful tools for health communication. Studying the content of substance use on visual social media may provide valuable insights into public health interventions. OBJECTIVE: This study aimed to explore and document the ways that betel nut is portrayed on the photo-sharing site Instagram. The analysis focuses on the hashtag #pugua, which refers to the local term for betel nut in Guam and other parts of Micronesia. METHODS: An exploratory content analysis of 242 Instagram posts tagged #pugua was conducted based on previous research on substance use and Instagram and betel nut practices in Micronesia. In addition, the study examined the social engagement of betel nut content on the image-based platform. RESULTS: The study findings revealed content themes referencing the betel nut or betel nut tree, betel nut preparation practices, and the unique social and cultural context surrounding betel nut activity in Guam and Micronesia. In addition, certain practices and cultural themes encouraged social engagement on Instagram. CONCLUSIONS: The findings from this study emphasize the cultural relevance of betel nut use in Micronesia. These findings provide a basis for empirically testing hypotheses related to the etiological roles of cultural identity and pride in shaping betel nut use behavior among Micronesians, particularly youths and young adults. Such research is likely to inform the development of culturally relevant betel nut prevention and cessation programs.

Tradition Gone Mobile: An Exploration of #Betelnut on Instagram.

Background: As a psychoactive substance that spans borders and cultures, researchers estimate that 600 million people use the areca nut. Despite its historical and geographical significance, betel nut use has received far less research attention than other stimulants such as tobacco, coffee or tea. Scholars have observed that social media platforms have significant effects on the promotion and use of addictive substances. Objectives: Our study investigates user practices and activities on a sample of Instagram posts tagged #betelnut dating back to 2011. Methods: Using social media analytics and hashtag network analysis, we examined user practices and activities on a sample of over 7800 Instagram posts tagged #betelnut dated between July 2011 to February 2019 that were collected in early 2019. Results: Findings determined that #betelnut is a growing topical hashtag on Instagram with content that drives social engagement. Importance: Co-occurring hashtags with #betelnut reflect regional language and cultural naming conventions that center around the Indian subcontinent and Melanesia. The importance of future work in this area is highlighted.