ASHES, Vol. 21(1) – r/ASHES: Content and post frequency in vape-cessation Reddit forums

One estimate suggests that nearly 24 million Americans aged 12+ experience nicotine dependence. E-cigarettes such as JUULrepresent the most commonly used tobacco product by youth and are projected to grow more popular with time. Because of the relative novelty and overall popularity of e-cigarettes, it is important to identify and understand the experiences of vape users who attempt to quit. This week, ASHES reviews a study by Elexis Kierstead and colleagues that analyzed posts on Reddit forums dedicated to quitting e-cigarettes. Notably, Reddit provides a unique opportunity to study the cessation experiences of people who vape due to its wealth of communities dedicated to such niche topics.

What were the research questions?
(1) How has the volume of posts and users that appear on vape cessation forums changed over time? (2) What kind of content is posted to vape cessation forums?

What did the researchers do?
The research team scraped all posts and comments from four vaping cessation forums on Reddit, spanning between January 12, 2015 through October 20, 2021. These data included the content of posts, when they were posted, which forum they were posted to, who posted it, and engagement (how many upvotes (i.e., likes) and comments the post received¹). To identify changes over time, the research team analyzed post trends descriptively. Two members of the research team then coded the content of posts to determine the themes present in each post.

What did they find?
Overall, this study analyzed 7110 posts from 3,197 unique users. Notably, vape cessation forums appeared to grow more popular over time, with significant peaks in activity around important events such as the FDA’s ban on flavored pod-based vapes. Six core themes and seven subthemes emerged across all posts. The major themes included topics such as personal narratives, social support, and quit strategies. Engagement varied between the themes, with posts focused on providing social support receiving the most engagement (see Figure).

Figure. Displays the frequency and engagement of posts within each theme and subtheme. Click image to enlarge.

Why do these findings matter?
These findings provide insight into the needs of people who vape but want to quit. To illustrate, the prevalence of posts related to seeking social support suggest that people who want to quit may not have the level of support they need. Therefore, interventions that focus on providing motivation via text messaging, such as the Truth Initiatives Ex Program, may be especially effective. Additionally, the prevalence of posts that include personal narratives suggest that people who vape put significant weight behind these narratives. Therefore, programs such as Smokefree.gov and their promotion of stories from former smokers may be especially effective in encouraging cessation.

Every study has limitations. What are the limitations in this study?
These findings may not be generalizable to the larger population of people who smoke as the sample derived from Reddit forums, which disproportionately include young white men. Additionally, because some posts were deleted by either users or moderators , the sample does not include all posts to these forums and may be biased towards certain kinds of posts.

For more information:
Individuals who want to quit vaping can find tips through the CDC. Alternative sources include The American Lung Association and the Truth Initiative. Additional resources can be found at the BASIS Addiction Resources page.

— John Slabczynski

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1. This review does not detail analyses focused on the median number of comments, as there was little variability on this measure.