title: Geographic variations in electronic cigarette advertisements on Twitter in the United States.
abstract: OBJECTIVE
  Studies have identified a proliferation of e-cigarette advertisements on Twitter. We investigate whether the prevalence of e-cigarette related advertising is associated with state tobacco regulations after taking socio-economic characteristics into account.
  
  
  METHODS
  We collected e-cigarette related tweets from July 23 to October 14, 2015 (n = 757,167) on Twitter. State regulations and smoking prevalence were provided by the Campaign for Tobacco-Free Kids program. The socio-economic data were provided by the American Community Survey.
  
  
  RESULTS
  The number of commercial tweets was 319,041/day with a high potential reach (830,495,700/day). The prevalence of commercial tweets varied significantly by US state. The higher prevalence of e-cigarette advertising was associated with states with better tobacco control impact (r = 0.54, p < 0.0001) and lower youth smoking prevalence (r = -0.39, p = 0.005). In the multivariate analysis, state tobacco control impact is significantly associated with the prevalence of commercial tweets (β = 0.03 ± 0.01, p = 0.02).
  
  
  CONCLUSIONS
  Policies at both the federal and state levels are needed to regulate the content of commercial tweets and mitigate the negative effect of social media advertisements.
authors.affiliation: Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, MO, USA. hdai@cmh.edu.|Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, USA. hdai@cmh.edu.|Department of Pediatrics, University of Missouri-Kansas City, Kansas City, USA. hdai@cmh.edu.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Multidisciplinary Studies, Indiana State University, Terre Haute, IN, USA.|The Center for Genomic Advocacy, Indiana State University, Terre Haute, IN, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Deem
authors.affiliation: Bellevue University, Omaha, NE, USA.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Hao
mesh_terms: D000329:Advertising / Q000639:trends*; D066300:Electronic Nicotine Delivery Systems; D005843:Geography; D006291:Health Policy / Q000331:legislation & jurisprudence; D006293:Health Promotion / Q000379:methods; D006801:Humans; D061108:Social Media / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States
keywords: Commercial; E-cigarette; Prevalence; Socio-economic factors; State regulation