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Tweets About Acute Nicotine Toxicity Due to e-Liquid Exposure

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Objectives: Intentional and unintentional exposures to electronic nicotine delivery system (ENDS) e-liquids can cause illness and death. In this study, we describe acute nicotine toxicity due to e-liquid exposure (ANTEE) information found on Twitter and contextualize ANTEE experiences to clarify conditions associated with exposure. Methods: We obtained 20,180 ANTEE- relevant tweets from 2013-2018. We excluded retweets, suspected bots, non-English tweets, tweets not originating in the US, and advertisements. We coded relevant tweets qualitatively using domains for e-liquid exposure tweets and e-liquid-related non-exposure tweets (ie, posts reflecting hypothetical exposure, information about e-liquids). Results: Content analyses were based on 1656 e-liquid exposure tweets and 1210 non-exposure tweets. More than half of exposure tweets (61.3%) were classified as accidental exposures; subjects were predominately young people, assumed to be under age 18 (40.5%), and self (27.7%). The most common exposure route was ingestion (61.1%). Of exposure tweets, 13.9% described health effects and 12.7% described seeking assistance. Most non-exposure tweets were classified as likely or hypothetical exposure (49.9%) or presentation of advice, information, or warnings (40.5%). Conclusions: Tweets can serve as a novel and complementary data source for learning more about e-liquid exposures.
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Keywords: E-CIGARETTE; E-LIQUID EXPOSURE; ELECTRONIC NICOTINE DELIVERY SYSTEMS; SOCIAL MEDIA; TWITTER

Document Type: Research Article

Affiliations: 1: Social Scientist, US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, United States 2: Health Scientist, US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, United States 3: Science Policy Analyst, US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD, United States

Publication date: January 2021

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  • Tobacco Regulatory Science (Electronic ISSN 2333-9748) is a rigorously peer-reviewed online scientific journal for the dissemination of research relevant to the regulation of tobacco products. The journal content includes a broad array of research domains, including chemistry, biology, behavior, community, and population-level surveillance and epidemiology, as well as knowledge syntheses (eg, meta-analyses or state-of-the-art reviews) and analytic modeling. All articles describe the policy relevance of the research outcomes. Given the global nature of tobacco regulation, particularly as a result of international and national policies, Tobacco Regulatory Science publishes high quality research that is relevant to global regulatory needs and requirements. Tobacco Regulatory Science is published electronically 6 times per year.
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