Keeping up with the times: how national public health and governmental organizations communicate about cannabis on Twitter

Twitter activity surrounding the Finnish green party's cannabis legalisation proposal: A mixed-methods analysis

Background: In September 2021, a Finnish political party, the Greens, voted to include cannabis policy reform in their party programme, which would legalise the use, possession, manufacture and sale of cannabis. A rapid public discussion has emerged on different social media platforms, including Twitter. Methods: We downloaded 10 days of Twitter data and prepared it for further text analysis, including sentiment, topic modelling and thematic content analysis. Results: Before the proposal, the average daily number of tweets was approximately 140. However, during the week of the proposal, there was a significant increase in tweet volume, reaching a peak of 6,600 tweets on a single day, with a daily average of over 2,700 tweets. Sentiment analysis showed that during the public discussion, the sentiment scores of the tweets were more likely to be positive. Through topic modelling analysis, we obtained the weight of the topic for each tweet, which enabled us to identify the most representative tweets in our corpus. To narrow the sample size for content analysis, we selected tweets that had a topic percentage distribution of over 0.95 (N=188) for closer thematic content analysis. Several positive and negative themes emerged, which were then categorised under broader topics. Similar themes were identified in the most retweeted, liked and commented tweets, which came mainly from known public figures, including politicians, health experts and NGO leaders. Conclusion: Our results show that the discussion was not limited to cannabis legalisation, but instead covered a variety of topics related to drug policy.

#TurntTrending: a systematic review of substance use portrayals on social media platforms

AIMS

There is a growing body of literature exploring the types of substance-related content and their portrayals on various social media platforms. We aimed to summarize how content related to substances is portrayed on various social media platforms.

METHODS

This systematic review was pre-registered on PROSPERO (ref: CRD42021291853). A comprehensive search was conducted in the databases of PubMed, Scopus, PsycINFO and Web of Science in April 2021. Original qualitative studies published post-2004 that included thematic and sentiment analyses of social media content on tobacco, alcohol, psychostimulant, e-cigarette, cannabis, opiate, stimulant/amphetamine, inhalant and novel psychoactive substance were included. Social media platforms were defined as online web- or application-based platforms that allowed users to generate content and interact via 'liking', comment or messaging features. Only studies that included summative and/or thematic content analyses of substance-related social media content were included.

RESULTS

A total of 73 studies, which covered 15 905 182 substance-related posts on Twitter, YouTube, Instagram, Pinterest, TikTok and Weibo, were identified. A total of 76.3% of all substance-related content was positive in its depiction of substance use, with 20.2% of content depicting use negatively. Sentiment regarding opiate use however was commonly negative (55.5%). Most studies identified themes relating to Health, Safety and Harms (65.0%) of substance use. Themes relating to Promotions/Advertisements (63.3%), Informative content (55.0%) and Use behaviours (43.3%) were also frequently identified.

CONCLUSIONS

Substance-related content that promotes engagement with substance use or actively depicts use appears to be widely available on social media. The large public presence of this content may have concerning influences on attitudes, behaviours and risk perceptions relating to substance use, particularly among the most vulnerable and heaviest users of social media-adolescents and young adults.

The Information Sharing Behaviors of Dietitians and Twitter Users in the Nutrition and COVID-19 Infodemic: Content Analysis Study of Tweets

Background

The COVID-19 pandemic has generated an infodemic, an overabundance of online and offline information. In this context, accurate information as well as misinformation and disinformation about the links between nutrition and COVID-19 have circulated on Twitter since the onset of the pandemic.

Objective

The purpose of this study was to compare tweets on nutrition in times of COVID-19 published by 2 groups, namely, a preidentified group of dietitians and a group of general users of Twitter, in terms of themes, content accuracy, use of behavior change factors, and user engagement, in order to contrast their information sharing behaviors during the pandemic.

Methods

Public English-language tweets published between December 31, 2019, and December 31, 2020, by 625 dietitians from Canada and the United States, and Twitter users were collected using hashtags and keywords related to nutrition and COVID-19. After filtration, tweets were coded against an original codebook of themes and the Theoretical Domains Framework (TDF) for identifying behavior change factors, and were compared to reliable nutritional recommendations pertaining to COVID-19. The numbers of likes, replies, and retweets per tweet were also collected to determine user engagement.

Results

In total, 2886 tweets (dietitians, n=1417; public, n=1469) were included in the analyses. Differences in frequency between groups were found in 11 out of 15 themes. Grocery (271/1417, 19.1%), and diets and dietary patterns (n=507, 34.5%) were the most frequently addressed themes by dietitians and the public, respectively. For 9 out of 14 TDF domains, there were differences in the frequency of usage between groups. “Skills” was the most used domain by both groups, although they used it in different proportions (dietitians: 612/1417, 43.2% vs public: 529/1469, 36.0%; P<.001). A higher proportion of dietitians’ tweets were accurate compared with the public’s tweets (532/575, 92.5% vs 250/382, 65.5%; P<.001). The results for user engagement were mixed. While engagement by likes varied between groups according to the theme, engagement by replies and retweets was similar across themes but varied according to the group.

Conclusions

Differences in tweets between groups, notably ones related to content accuracy, themes, and engagement in the form of likes, shed light on potentially useful and relevant elements to include in timely social media interventions aiming at fighting the COVID-19–related infodemic or future infodemics.

The Volume and Tone of Twitter Posts About Cannabis Use During Pregnancy: Protocol for a Scoping Review

Background

Cannabis use has increased in Canada since its legalization in 2018, including among pregnant women who may be motivated to use cannabis to reduce symptoms of nausea and vomiting. However, a growing body of research suggests that cannabis use during pregnancy may harm the developing fetus. As a result, patients increasingly seek medical advice from online sources, but these platforms may also spread anecdotal descriptions or misinformation. Given the possible disconnect between online messaging and evidence-based research about the effects of cannabis use during pregnancy, there is a potential for advice taken from social media to affect the health of mothers and their babies.

Objective

This study aims to quantify the volume and tone of English language posts related to cannabis use in pregnancy from January 2012 to December 2021.

Methods

Modeling published frameworks for scoping reviews, we will collect publicly available posts from Twitter that mention cannabis use during pregnancy and use the Twitter Application Programming Interface for Academic Research to extract data from tweets, including public metrics such as the number of likes, retweets, and quotes, as well as health effect mentions, sentiment, location, and users’ interests. These data will be used to quantify how cannabis use during pregnancy is discussed on Twitter and to build a qualitative profile of supportive and opposing posters.

Results

The CHEO Research Ethics Board reviewed our project and granted an exemption in May 2021. As of December 2021, we have gained approval to use the Twitter Application Programming Interface for Academic Research and have developed a preliminary search strategy that returns over 3 million unique tweets posted between 2012 and 2021.

Conclusions

Understanding how Twitter is being used to discuss cannabis use during pregnancy will help public health agencies and health care providers assess the messaging patients may be receiving and develop communication strategies to counter misinformation, especially in geographical regions where legalization is recent or imminent. Most importantly, we foresee that our findings will assist expecting families in making informed choices about where they choose to access advice about using cannabis during pregnancy.

Trial Registration

Open Science Framework 10.17605/OSF.IO/BW8DA; www.osf.io/6fb2e

International Registered Report Identifier (IRRID)

PRR1-10.2196/34421

Geographic Differences in Cannabis Conversations on Twitter: Infodemiology Study

BACKGROUND

Infodemiology is an emerging field of research that utilizes user-generated health-related content, such as that found in social media, to help improve public health. Twitter has become an important venue for studying emerging patterns in health issues such as substance use because it can reflect trends in real-time and display messages generated directly by users, giving a uniquely personal voice to analyses. Over the past year, several states in the United States have passed legislation to legalize adult recreational use of cannabis and the federal government in Canada has done the same. There are few studies that examine the sentiment and content of tweets about cannabis since the recent legislative changes regarding cannabis have occurred in North America.

OBJECTIVE

To examine differences in the sentiment and content of cannabis-related tweets by state cannabis laws, and to examine differences in sentiment between the United States and Canada between 2017 and 2019.

METHODS

In total, 1,200,127 cannabis-related tweets were collected from January 1, 2017, to June 17, 2019, using the Twitter application programming interface. Tweets then were grouped geographically based on cannabis legal status (legal for adult recreational use, legal for medical use, and no legal use) in the locations from which the tweets came. Sentiment scoring for the tweets was done with VADER (Valence Aware Dictionary and sEntiment Reasoner), and differences in sentiment for states with different cannabis laws were tested using Tukey adjusted two-sided pairwise comparisons. Topic analysis to determine the content of tweets was done using latent Dirichlet allocation in Python, using a Java implementation, LdaMallet, with Gensim wrapper.

RESULTS

Significant differences were seen in tweet sentiment between US states with different cannabis laws (P=.001 for negative sentiment tweets in fully illegal compared to legal for adult recreational use states), as well as between the United States and Canada (P=.003 for positive sentiment and P=.001 for negative sentiment). In both cases, restrictive state policy environments (eg, those where cannabis use is fully illegal, or legal for medical use only) were associated with more negative tweet sentiment than less restrictive policy environments (eg, where cannabis is legal for adult recreational use). Six key topics were found in recent US tweet contents: fun and recreation (keywords, eg, love, life, high); daily life (today, start, live); transactions (buy, sell, money); places of use (room, car, house); medical use and cannabis industry (business, industry, company); and legalization (legalize, police, tax). The keywords representing content of tweets also differed between the United States and Canada.

CONCLUSIONS

Knowledge about how cannabis is being discussed online, and geographic differences that exist in these conversations may help to inform public health planning and prevention efforts. Public health education about how to use cannabis in ways that promote safety and minimize harms may be especially important in places where cannabis is legal for adult recreational and medical use.