Viewer Reactions to EVALI Storylines on Popular Medical Dramas: A Thematic Analysis of Twitter Messages.

Previous research has found an association between awareness of e-cigarette, or vaping, product-use associated lung injury (EVALI) and lower intention to use e-cigarettes among young people. This study utilized Twitter data to evaluate if the January 2020 depiction of EVALI on New Amsterdam, Chicago Med, and Grey's Anatomy-three popular primetime medical dramas-could be a potential innovative avenue to raise awareness of EVALI. We obtained tweets containing e-cigarette-related search strings from 1/21/2020 to 02/18/2020 and filtered these with storyline-specific keywords, resulting in 1,493 tweets for qualitative coding by two trained human coders. Content codes were informed by prior research, theories of narrative influence, and e-cigarette related outcomes. Of 641 (42.9%) relevant tweets, the most frequent content codes were perceived realism (n = 292, 45.6%) and negative response (n = 264, 41.2%). A common theme among these tweets was that storylines were unrealistic because none of the characters with EVALI used THC-containing products. Approximately 12% of tweets (n = 78) mentioned e-cigarette knowledge and 28 (4.4%) mentioned behavior, including quitting e-cigarettes because of viewing the storylines. Implications for health communication research utilizing social media data and maximizing the achievement of positive health-related outcomes for storylines depicting current health topics are discussed.

Characterizing online social support for alcohol use disorder: A mixed-methods approach.

BACKGROUND: Online social media communities are increasingly popular venues for discussing alcohol use disorder (AUD) and recovery. Little is known about distinct contexts of social support that are exchanged in this milieu, which are critical to understanding the social dynamics of online recovery support. METHODS: We randomly selected one post per day over the span of a year from the StopDrinking recovery forum. Direct responses to posts were double coded within an established theoretical framework of social support. Within a mixed-methods research framework, we quantified the linguistic characteristics of 1386 responses (i.e., text length, complexity, and sentiment) and qualitatively explored themes within and among different types of social support. RESULTS: Emotional support was most prevalent (74% of responses) and appeared as the sole form of support in 38% of responses. Emotionally supportive responses were significantly shorter, less complex, and more positively valenced than other support types. Appraisal support was also common in 55% of responses, while informational support was identified in only 17%. There was substantial overlap among support types, with 40% of responses including two or more types. Salient themes included the common use of community-specific acronyms in emotional support. Appraisal support conveyed feedback about attitudes and behaviors that are perceived as (un-) favorable for AUD recovery. Informational support responses were composed primarily of recommendations for self-help literature, clinical treatment approaches, and peer recovery programs. CONCLUSIONS: Social support in this sample was primarily emotional in nature, with other types of support included to provide feedback and guidance (i.e., appraisal support) and supplemental recovery resources (i.e., informational support). The provided social support framework can be helpful in characterizing community dynamics among heterogeneous online AUD recovery support forums. This framework could also be helpful in considering changes in support approaches that correspond to progress in recovery.

JUUL on Twitter: Analyzing Tweets About Use of a New Nicotine Delivery System.

BACKGROUND: Initial reports suggest that JUUL, a popular e-cigarette, is being used in schools and other locations in which cigarette smoking is illegal or discouraged. However, there is little scholarly research documenting this. We aimed to make a systematic analysis of JUUL use themes and sentiment on Twitter. METHODS: Data were collected from Twitter's Filtered Streams Application Programming Interface from April 12, 2018 to May 10, 2018. This yielded 67,934 tweets, from which a random sample of 2% was selected for coding. The final dataset included 1209 tweets. Inter-rater reliability ranged κ = 0.64-0.85. RESULTS: The majority (71.5%) of tweets expressed positive sentiment toward JUUL. JUUL use in places where cigarette smoking is illegal or discouraged appeared in 111 tweets (9.2%); approximately one-third of these tweets referring to using the device in school. Nearly 20% of tweets mentioned using the device at home and/or directly in front of responsible adults. CONCLUSIONS: This study confirms anecdotal reports of JUUL use in places where cigarette smoking is illegal or discouraged. Positive sentiment about use of JUUL suggests that the product is being normalized among young people. It may be valuable for educators to discuss the addictive nature of nicotine delivered through JUUL with younger populations.

I wake up and hit the JUUL: Analyzing Twitter for JUUL nicotine effects and dependence.

BACKGROUND: JUUL-a novel electronic nicotine delivery system (ENDS)-comprises most of the ENDS market share. Additionally, JUUL has a high nicotine content and utilizes a patented nicotine salt formulation aimed to speed absorption. Many JUUL users are not aware of the nicotine content and therefore may not be expecting acute nicotine effects or potential for dependence. This study sought to analyze Twitter messages ("tweets") regarding nicotine, symptoms of dependence, and withdrawal related to JUUL use. METHODS: Data were collected from Twitter's Filtered Streams interface 4/11-6/16/2018 by retrieving tweets matching the terms "juul," "juuls," and "juuling" that also used words consistent with nicotine effects, symptoms of dependence, and withdrawal. A random 5% subsample (n = 1986) was coded by 2 independent coders. Cohen's κ for inter-rater reliability ranged 0.62-1.00 for all coded variables. Tweets were assessed using a qualitative content analysis approach. RESULTS: A total of 335 tweets mentioned dependence-related themes, including use upon waking and compulsion to use. A total of 189 tweets mentioned themes related to nicotine, with almost 15% of these tweets describing physical effects. Additionally, 42 tweets mentioned themes related to quitting JUUL and/or withdrawal from JUUL. DISCUSSION: This qualitative analysis suggests that users of JUUL are experiencing symptoms of nicotine exposure and dependence. Considering the high nicotine content of JUUL and the rising popularity among young people, more research around initiation of and dependence on JUUL, as well as the impact of recent FDA policy changes, should be conducted.

Youth risk behavior surveillance--selected Steps communities, United States, 2007.

PROBLEM: Priority health-risk behaviors, including tobacco use, unhealthy dietary behaviors, and physical inactivity often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. These behaviors contribute to chronic disease and other health conditions, including asthma. REPORTING PERIOD COVERED: January--May 2007. DESCRIPTION OF SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors and the prevalence of obesity and asthma among youth and young adults. YRBSS includes a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education and health agencies. In 2007, as a component of YRBSS, communities participating in the Steps Cooperative Agreement Program (Steps Program) also conducted school-based surveys of students in grades 9--12 in their program intervention areas. These communities used a standard questionnaire that measured tobacco use, dietary behaviors, and physical activity and monitored the prevalence of obesity and asthma. This report summarizes results from surveys of students in 26 Steps communities that conducted surveys in 2007. RESULTS: Results from the 26 Steps communities indicated that a substantial proportion of adolescents engaged in health-risk behaviors that increased their likelihood of becoming obese. During 2007, across surveys, the percentage of high school students who had ever smoked at least one cigarette every day for 30 days ranged from 3.7% to 20.1% (median: 9.0%), the percentage who had eaten fruits and vegetables five or more times per day during the 7 days before the survey ranged from 13.9% to 23.9% (median: 17.9%), and the percentage who met recommended levels of physical activity ranged from 27.7% to 55.5% (median: 40.1%). Across surveys, the percentage of students who were obese ranged from 4.6% to 20.2% (median: 13.6%), and the percentage of students who had ever been told by a doctor or nurse that they had asthma ranged from 16.8% to 28.5% (median: 21.6%). INTERPRETATION: Although the prevalence of many health-risk behaviors and health conditions related to obesity and asthma varies across Steps communities, a substantial proportion of high school students engage in behaviors that place them at risk for chronic disease. PUBLIC HEALTH ACTION: Steps Program staff at the national, tribal, state, and local levels will use YRBSS data for decision making, program planning, and enhancing technical assistance to reduce tobacco use and exposure and to increase healthy eating and physical activity. These data will be used to help focus existing programs on activities that have shown the greatest promise of results, as well as identify populations of greatest need and opportunities for strategic collaboration to identify and disseminate lessons learned.

Pharmacokinetics of melamine in pigs following intravenous administration.

Melamine-contaminated pet food was recently added as a supplement to livestock feed. There is little or no information concerning the pharmacokinetics of melamine in livestock, and the aim of this study was to obtain pharmacokinetic parameters for this contaminant in pigs. Melamine was administered intravenously to five weanling pigs at a dose of 6.13 mg/kg and plasma samples were collected over 24 h, extracted for melamine, and then analyzed by HPLC-UV. The data was shown to best fit a one-compartment model with melamine's half-life of 4.04 (+/- 0.37) h, clearance of 0.11 (+/- 0.01) L/h/kg, and volume of distribution of 0.61 (+/- 0.04) L/kg. These data are comparable to the only mammalian study in rats and suggests that melamine is readily cleared by the kidney and there is unlikely to be significant tissue binding. Further tissue residue studies are required to assess the depletion kinetics of this contaminant in the pig which will determine whether residue levels in the kidney should be of public health concern if pigs were exposed to a similar dose.