title: Vaping on Instagram: cloud chasing, hand checks and product placement.
abstract: This study documented images posted on Instagram of electronic cigarettes (e-cigarette) and vaping (activity associated with e-cigarette use). Although e-cigarettes have been studied on Twitter, few studies have focused on Instagram, despite having 500 million users. Instagram's emphasis on images warranted investigation of e-cigarettes, as past tobacco industry strategies demonstrated that images could be used to mislead in advertisements, or normalise tobacco-related behaviours. Findings should prove informative to tobacco control policies in the future.
  
  
  
  3 months of publicly available data were collected from Instagram, including images and associated metadata (n=2208). Themes of images were classified as (1)activity, for example, a person blowing vapour; (2)product, for example, a personal photo of an e-cigarette device; (3)advertisement; (4)text, for example, 'meme' or image containing mostly text and (5)other. User endorsement (likes) of each type of image was recorded. Caption text was analysed to explore different trends in vaping and e-cigarette-related text.
  
  
  
  Analyses found thatadvertisement-themed images were most common (29%), followed byproduct(28%), andactivity(18%). Likes were more likely to accompanyactivityandproduct-themed images compared withadvertisementortext-themed images (p<0.01). Vaping-related text greatly outnumbered e-cigarette-related text in the image captions.
  
  
  
  Instagram affords its users the ability to post images of e-cigarette-related behaviours and gives advertisers the opportunity to display their product. Future research should incorporate novel data streams to improve public health surveillance, survey development and educational campaigns.
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Kar-Hai
authors.initials: KH
authors.lastname: Chu
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Jon-Patrick
authors.initials: JP
authors.lastname: Allem
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Tess Boley
authors.initials: TB
authors.lastname: Cruz
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Unger
mesh_terms: D000329:Advertising; D066300:Electronic Nicotine Delivery Systems; D006801:Humans; D012907:Smoking; D061108:Social Media; D062789:Tobacco Products; D000072137:Vaping
keywords: Advertising and Promotion; Electronic nicotine delivery devices; Media; Social marketing; Surveillance and monitoring