#Discreetshipping: Selling E-cigarettes on TikTok.

INTRODUCTION: Youth and young adult use of e-cigarette products continues to remain high despite regulatory approaches to reduce youth access. This study sought to examine TikTok content regarding the sale and distribution of e-cigarettes. AIMS AND METHODS: TikTok videos (n = 475) and metadata posted between June 2022 and August 2023 were scraped using a TikTok application programming interface and popular hashtags used to sell vaping products (ie, #discreetshipping [40.8 million], #puffbundle [14.8 million], #hiddennic [1.0 million]). After watching the 25 most viewed videos (39 600-868 800 views), a codebook was developed. All metadata were annotated using 11 unique codes: Small business, brand, cannabis, bundled, hidden, fake, international sales, no ID, order via Instagram, order via another method, and cost. RESULTS: Overall, 367 videos (with an average of 2017 likes) were deemed relevant. Videos advertised popular vaping brands (50.4%) that included cannabis products (45%). Products were described as bundled (28.6%), hidden (8.7%), and able to be shipped internationally (6%) without age verification (45.2%). Some videos (8.2%) evaded algorithms' detection of illegal activity by describing the post as "Fake." Customers were directed to other social media platforms (most often Instagram, 57.5%) and/or other websites/links (58.3%) to purchase products; 22.1% advertised discounts, free shipping, or low costs (ranging from $25-$35). CONCLUSIONS: Social media platforms, such as TikTok and Instagram, are being used to circumvent e-cigarette regulatory policies. Regulatory agencies should expand enforcement strategies to include social media platforms where users are illegally selling and distributing e-cigarettes internationally to young audiences. IMPLICATIONS: TikTok users across the globe are violating local, state, and federal laws by selling e-cigarettes concealed inside other products or bundled in packages that avoid detection. TikTok videos posted by self-proclaimed small business owners advertise discreet shipping practices that evade age verification in order to sell nicotine and cannabis bundles worldwide. Accounts used phrases describing the post to be "fake" to avoid detection by algorithms or TikTok administrators. E-cigarette regulatory agencies can partner with social media platforms to close regulatory gaps.

Cigarette and E-Cigarette Harm Perceptions During Pregnancy.

BACKGROUND: Research suggests that pregnancy status (prior, current, and future intention) is associated with differences in perceived harm of electronic cigarette (e-cigarette) use during pregnancy. However, perceptions of health outcomes attributed to cigarette and e-cigarette use during pregnancy have not been explored among a sample of pregnant women who smoke. OBJECTIVES: The purpose of this study was to explore differences in perceived harms of cigarette and e-cigarette use and perceived birth and health outcomes associated with cigarette and e-cigarette use during pregnancy among a sample of pregnant women who currently smoked. METHODS: Using a cross-sectional online survey, we examined perceptions about cigarette and e-cigarette use during pregnancy among a sample of U.S. pregnant women ( n = 267) who smoked in the past 30 days. Participants were grouped into categories based on e-cigarette use status (current, past, and never e-cigarette users). Differences between e-cigarette use status and perceived harm (absolute of cigarettes, e-cigarettes, and relative of e-cigarettes) and perceived health outcomes attributed to smoking/e-cigarette use were examined. RESULTS: Among our sample, 45.7%, 39.7%, and 14.6% were current, ever, and never e-cigarette users, respectively. Associations existed between e-cigarette use status and absolute perceived harm of cigarettes, relative perceived harm of e-cigarettes, and perceived health outcomes. Current e-cigarette users believed pregnant women who smoked cigarettes were more likely to lose a child because of miscarriage or sudden infant death syndrome or give birth to a child with low birth weight, reduced lung function, cleft lip, reduced brain function, or attention-deficit/hyperactivity disorder than never e-cigarette users. No associations were found between perceived birth and health outcomes of e-cigarette use by e-cigarette user status. DISCUSSION: Pregnant women who smoked and used e-cigarettes had lower risk perceptions about e-cigarette use during pregnancy than those who only smoked. Health messages and research about the harms of nicotine exposure during pregnancy should address the risks of dual-use versus only e-cigarette use. In addition, messages about the relative harm of e-cigarettes compared to cigarettes are needed for pregnant women who smoke and have trouble quitting.

Miscommunication about the US federal Tobacco 21 law: a content analysis of Twitter discussions.

OBJECTIVE: Tobacco 21 is a law that sets the minimum legal sales age of tobacco products to 21. On 20 December 2019, the USA passed a federal Tobacco 21 law. The objective of this study is to explore Twitter discussions about the federal Tobacco 21 law in the USA leading up to enacted. METHODS: Twitter messages about Tobacco 21 posted between September and December 2019 were collected via RITHM software. A 2% sample of all collected tweets were double coded by independent coders using a content analysis approach. RESULTS: Findings included three content categories of tweets (news, youth and young adults and methods of avoiding the law) with eight subcodes. Most news tweets incorrectly described the law as a purchase law (54.7%). However, Tobacco 21 is in fact a sales law-it only includes penalties for tobacco retailers who sell to under-age purchasers. About one-fourth (27%) of the tweets involved youth and young adults, with some claiming the law would reduce youth smoking and others doubting its ability to limit youth access to tobacco products. Few tweets (2.5%) mentioned methods of circumventing the policy, such as having an older peer purchase tobacco. CONCLUSIONS: As several countries explore raising their age of sale of tobacco laws to 21, they should couple policy enactment with clear and accurate communication about the law. Compliance agencies at all levels (eg, local, regional, national) can use social media to identify policy loopholes and support vulnerable populations throughout the policy implementation process.

Assessing Sorority Women's Perceptions of Barriers to Reporting Sexual Assaults That Occur Within College Campus Greek Organizations.

Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur.

Associations of Alcohol Consumption, Sexual Assault History, Severity, and Revictimization With College Women's Bystander Behaviors in Alcohol-involved Settings.

Sexual assault victimization (SAV) histories may impede, increase, or have no effect on women's risk recognition. Yet, even though risk recognition is a component of bystander intervention, the effect of SAV on bystander behaviors is understudied. For example, how different SAV histories, such as the severity of the assault and if women were revictimized since entering college, have not been examined with bystander behaviors; we intended to address this gap in the literature. Building on recent work, we also examined the potential interactive effects of alcohol consumption and SAV history in predicting bystander behaviors. College women (n = 560) completed a web-based survey on alcohol consumption, SAV experiences since entering college, and bystander behaviors in alcohol-involved settings. We found that the effect of SAV history on bystander behavior varied based on alcohol consumption. As women's alcohol consumption increased so did their self-reported engagement in bystander behaviors. For non-victims, increased alcohol consumption had a greater positive effect on their bystander behaviors than victims. However, after a certain quantity of alcohol was consumed, both victims and non-victims reported decreased bystander behavior. Finally, alcohol consumption did not interact with severity of SAV or revictimization status in predicting bystander behavior. Findings suggest alcohol consumption may be more influential on bystander behaviors for women with no history of SAV; however, consuming a greater quantity of alcohol is related to a decrease in bystander behavior-regardless of SAV history. Given these findings, more work is needed to explore when and how alcohol impedes, and potentially encourages, bystander behavior. How SAV histories relate to bystander behaviors also warrants further research.