Analysis of comments in a petition defending electronic cigarettes.
BACKGROUND
A 2009 petition opposing a Food and Drug Administration (FDA) ban on electronic cigarettes (e-cigs) garnered international attention from e-cig users (vapers). Petitioners' comments described the perceived benefits of vaping.


METHODS
We conducted a qualitative and quantitative analysis of petitioners' comments. A sample of 200 petitioner names was sought in public records. Reviewers identified 13 major themes in a sample of comments, and themes related to current controversies were added. For each theme, software pattern-matching instructions (regular expressions) were developed and were used to scan comments. Agreement between reviewers and software was calculated; theme prevalence and clustering was ascertained.


RESULTS
A total of 13,414 signatures and 8,285 comments from 50 states and 75 nations were collected in 6 months. Temporal patterns and name matches in public records suggest that most petitioners are authentic. Agreement between reviewers and software was moderate to high (κ = 0.4-0.8). Commonly cited themes were "e-cigs helped me quit" (34%), "a ban would be counterproductive" (15%), and "my health improved with e-cigs" (13%). Two clusters of themes emerged: the first combined comments about smoking cessation, health benefits, and smoking relapse that an e-cig ban would cause; the second combined themes that a "ban would be counterproductive," it would infringe on personal liberties, and it was motivated by government or industrial greed. People who cited mental health issues often mentioned avoiding withdrawal as a benefit of e-cigs.


CONCLUSIONS
Early e-cig adopters were both frustrated and confused by discussion of a ban. They believed that e-cigs safely delivered nicotine and helped them quit smoking.
St. Louis University, St. Louis, MO;
Holly Marie
HM
Sumner
Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO.
Amy
A
McQueen
Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO.
Michael John
MJ
Scott
Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO wsumner@dom.wustl.edu.
Walton
W
Sumner
D003258:Consumer Behavior; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D009538:Nicotine / Q000008:administration & dosage; D012008:Recurrence; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D014481:United States / Q000453:epidemiology
D009538:Nicotine