INTRODUCTION

After decades of decline in the use of combustible tobacco products such as cigarettes, new tobacco products such as electronic cigarettes (e-cigarettes) are becoming increasingly popular among adults and youth in the United States and worldwide^1-5. Some e-cigarette products might be less harmful than combustible products, but there is still risk to health from the nicotine, the specific flavorings and compounds produced by the aerosolization (vaporization) process⁶. E-cigarettes may contribute to initiation of cigarettes among adolescents⁷, and/ or recruit youth and non-smokers to nicotine experimentation and dependence. The effectiveness of e-cigarettes for cigarette smoking cessation is still unknown^8,9. However, recent research suggests that e-cigarettes are more effective for smoking cessation than nicotine-replacement therapy, when both products are accompanied by behavioral support¹⁰.

Product design features elicit lasting psychological and behavioral responses among consumers¹¹. Currently, e-cigarette products vary in their construction, appearance, composition of e-liquids, and component parts (e.g. cartridge capacity, coil type, heating mechanisms, and battery size)¹², which may have implications for product appeal, frequency of use, and associated health effects¹³. For example, open-system pod mods, offering flexibility of use in terms of nicotine and cannabis vaping, raise concerns about abuse liability¹⁴. Devices with variable wattage, also often release high levels of harmful toxicants under higher power conditions¹⁵. Replaceable coils in devices produce dense vapor¹⁶, which is an appeal factor communicated on social media in the form of ‘cloud chasing’ (blowing large clouds)¹⁷. E-cigarette users generally transition between device types, using modifiable devices (rather than first generation or ‘cigalike’ products) more regularly as a function of time and as their familiarity grows with the products^18,19. Further information on product design features may prove helpful in understanding the growth in popularity of e-cigarettes and changes in patterns of use over time.

Publicly accessible data from social media platforms (like Twitter and Instagram) have been used in prior research to capture and document the environmental context and appeal of e-cigarette use^20-22. Such platforms may also be able to provide insight to the product design features of e-cigarettes that increase their appeal to current and potential users. Social media platforms facilitate rapid data collection, capturing organic conversations about topics of great import (like e-cigarettes) from the public in their own words. In this way, information pulled from social media can be treated like a focus group^20-22.

Reddit (reddit.com) is a popular online discussion forum that allows users to create, vote, and comment on posts covering a wide range of topics called sub-reddits. In January 2019, Reddit was estimated to be the 5th most popular website in the United States and 18th most popular website in the world²³. Exposure to online reviews of products, a form of electronic word-of-mouth²⁴, is associated with high purchase intentions²⁵ and facilitates decision making²⁶. Product reviews have been described as useful in helping to forecast the popularity of products²⁷. In some instances, sub-reddits contain product reviews as part of their ‘wiki’ (a webpage that allows collaborative editing of its content and structure by its users). Reddit has been used in prior research focused on tobacco use^28-30, cannabis use^31-32, and other health-related areas^33-35. Reddit is a platform where consumers may collaborate to seek information, share questions and experiences of products³⁶. To date, prior research has not examined e-cigarette product reviews on Reddit As such, this study analyzed e-cigarette product reviews on Reddit to attempt to arrive at a greater understanding of the features of e-cigarette products that may make them appealing to current users.

METHODS

Data collection comprised a sample of product reviews found on the popular (>166 thousand subscribers at the time of data collection) e-cigarette-related sub-reddit (https://www.reddit.com/r/electronic_cigarette/). A sub-reddit can be considered an online community that discuses a specific topic, which is governed by its own set of rules that are enforced by its active subscribers and moderators. The product reviews were ‘scraped’ (copied using a computer program written in Python)³⁷, from the sub-reddit’s ‘wiki’ (https://www.reddit.com/r/electronic_cigarette/wiki/anthony_vapes_reviews) - a community-maintained set of documents containing, in addition to product reviews, vaping tutorials, responses to frequently asked questions to aid e-cigarette users and guide new subscribers to the sub-reddit.

At the time of data collection (15 November 2018), there were 248 reviews in total, each for a different product. Reviews were dated from 10 April 2017 to 12 November 2018. Each review consisted of several sub-sections, some exclusive to a single product, while others were common among all products. For this study we examined the sub-sections relating to the positive features (PFs) and negative features (NFs) of the product found in each review. There were 2929 comments on PFs (average 12 per product), and 1003 on NFs (average 4 per product).

To systematically identify commonly occurring themes in the PF and NF sections of the reviews, the data (e.g. the entire text from each specific review) were pre-processed by: 1) lower casing all words, 2) removing stop words (e.g. words such as ‘a’ and ‘the’) and punctuations, and 3) lemmatizing words (e.g. breaking down words into their basic form by removing inflections and variants). Two authors read the most commonly occurring set of words and phrases in the reviews. From this initial assessment of the data, ten themes were identified by the authors. Most PF and NF comments were four to five words long, and could be classified into one (or more) of ten themes (Table 1) with simple word or phrase matching. Phrase matching is accomplished by looking for the presence of all words in a document where the order of words does not matter. The words used to identify themes are provided in Table 1. Themes are presented as percentages in reviews. Multiple themes could occur in each PF and NF section of a review. To illustrate findings, we paraphrased sections of reviews for themes.

Data collection and analyses were approved by the Institutional Review Board of the authors’ university.

RESULTS

DISCUSSION

The themes identified in this study of e-cigarette product reviews on Reddit provide insight to the device features that may appeal to e-cigarette users. Findings suggest that e-cigarette users expect quality devices, and have developed ways to discriminate between devices that perform well from those that do not. These include good quality threading, an excellent tank, and lack of rattling or loose component parts. Easy access to the battery with a well-functioning battery door, sturdy tips, screws, and component parts that are compatible across different products were also noted as positive features of e-cigarette devices. Members of tobacco-related forums may represent a ‘hobbyist culture’ that actively engages in information exchange, including discussions of equipment and techniques³⁸. Our findings echo this position. Researchers in tobacco control may want to further explore discussion forums, like Reddit, to better understand what drives the appeal of tobacco products, to inform regulation.

Many themes, identified in this study, point to the importance of performance of e-cigarette device components, including the coil, tip, tank, and other parts. Prior research has reported that e-cigarette users prefer advanced devices to the initial lines of e-cigarette or ‘cigalike’ products³⁹. Earlier research has also reported that experienced e-cigarette users prefer devices that are capable of being modified with variable voltage and/or wattage for a specific experience such as the ability to create a thick/milky cloud⁴⁰. This poses a public health concern as devices with variable wattage often release high levels of harmful toxicants under high power conditions¹⁵.

Color was identified as a prominent theme in the present study. Findings suggest that e-cigarette users approve of devices offered in a variety of colors, especially bright colors. Recent work suggests that product appearance, including device color, is a predominant theme among discussions about e-cigarettes on Instagram¹⁴. Emphasizing product appeal by highlighting device color has also been a key e-cigarette marketing strategy⁴¹. Device appearance, e.g. standardizing color, may be one of many features that could be considered a target in future policies addressing e-cigarette use.

Price was also identified as a prominent theme. The findings suggest that e-cigarette users find it reasonable to pay 30–39 US$ for their devices. Earlier focus groups among adolescents and young adults demonstrated that high costs of e-cigarette devices motivated discontinuation among lifetime e-cigarette users, while low cost was identified as a reason for e-cigarette experimentation⁴². Future targets for regulation could involve taxation of e-cigarettes to address concerns related to experimentation and abuse liability.

Compatibility across multiple products, and size were common aspects of the battery quality theme. Small battery size was identified as preferable, possibly considered sleeker, pointing to another design feature that could be regulated in the future. Prior research has documented that the overall size and sleek shape of e-cigarette devices (especially JUUL) were discussed features on social media including among youth^22,43. Modular and compatible e-cigarette designs may facilitate transition across different types of devices (e.g. closed-system, open-system, mods, pods) and raise implications for abuse liability. Future targets for regulation could involve standardizing the shape of e-cigarette devices (e.g. making them larger and ultimately more awkward to conceal), and limiting their compatibility (e.g. closed-systems).

CONCLUSIONS

Build quality, device component quality (screw, coil, battery, tank), performance, color, price and size were common features discussed in reviews on e-cigarette products. Controlling the design features of e-cigarette products, for example standardizing size, color and wattage, to make them appeal to adult cigarette smokers attempting to quit, but not to youth or non-smokers, warrants consideration for future research and policies addressing e-cigarette use.