When it comes to tweets promoting vape use as a healthy alternative to cigarettes, roughly three out of four are likely generated or amplified by bots — automatic computer programs that also appear eager to encourage e-cigarette sales, according to new research.
A study by the Nicholson Foundation and the Public Good Projects found bots play an outsized role in broadcasting positive social media messages around the use of these devices and frequently include misinformation about the potential benefits of electronic cigarettes.
“It’s a war where one side has a lot more guns and ammunition and is a lot more savvy” when it comes to using social media to distribute their message, said Joe Smyser, CEO of the Public Good Projects, a national nonprofit focused on public health. Nicholson works to improve underserved communities in New Jersey.
Smyser hopes the report — which also included a broader public media review, plus analysis of the topic areas and words used by each group — will help raise public awareness about the role automatic technology plays in this debate and encourage a more robust counter-narrative from legitimate public health sources.
“The public health sector is behind the eight ball on this now,” Smyser added. In fact, the opposition has rallied since the report was released earlier this week and hashtags like #NotABot and #IVapeIVote have suddenly proliferated on Twitter, he said.
The role of bots in pro-vape messaging is already facing scrutiny in Congress, as part of the Energy and Commerce Committee’s broader investigation of e-cigarette makers. The committee, chaired by U.S. Rep. Frank Pallone (D-6th), launched the ongoing investigation in August. Pallone has also introduced legislation designed to discourage young people from using these products.
Vape use has soared in recent years, particularly among young people, and has now been linked to more than two dozen deaths nationwide, including a woman from north Jersey and a New York City teenager. While the devices — which heat liquid infused with nicotine or a marijuana-based chemical, and often flavoring, to create a vapor that is inhaled — do not create the same cancer-causing tar as traditional cigarettes, they contain far more addictive nicotine, and little is known about the long-term health effects.
In their review of more than 1.3 million Twitter posts, researchers from Nicholson and PGP found fewer than 23% of these posts were likely generated by human hands alone. More than 77% of these tweets had characteristics suggesting they came from a bot, or someone using technology to enhance their own communication ability with more frequent or targeted posts. Bots can be camouflaged as a legitimate user, complete with a personal profile, but function automatically to post multiple messages on a topic, or search and respond to other users or conversations based on programmed keywords.
Pro-vapers speak up
Former New Jersey Department of Health Commissioner Dr. Shereef Elnahal, now CEO of Newark’s University Hospital, said Wednesday that he felt the wrath of pro-vaping posters personally when he tweeted what he called a “light-hearted public health message” last summer. Using punctuation to create a “sign bunny” with a placard stating “VAPING ISNT A SAFE REPLACEMENT FOR CIGARETTES,” Elnahal’s tweet quickly attracted more than 1,000 likes, but also plenty of opposition.
“This research is disappointing but not surprising,” Elnahal said of the Nicholson/PGP report. “The messaging tactics of the industry and its representatives have been aggressive, dismissive concerning the science and evidence, and, frankly, one-sided and financially motivated,” he added.
But Gregory Conley, a New Jersey resident who heads the American Vaping Association, an industry-funded public policy group, strongly criticized the Nicholson/PGP study on Wednesday. Conley — who was among those sparring with Elnahal last summer — said a researcher active in the vaping debate was able to identify real people behind four of five examples of likely bots authors of the study had shared, which he said raises questions about the legitimacy of their work overall.
“Their methods are so incompetent,” Conley said. “How the hell do you trust anything else in the study?”
The report also includes an analysis of a small fraction of these posts considered specific to New Jersey (some 14,000 total), which indicated human engagement on the topic is even more limited in the Garden State, where nine in 10 tweets are likely to come from bots or technologically enhanced human actions. Roughly half of these automatically generated messages mentioned sales, researchers found, nearly double the rate seen on the national scale.
Online sales are a huge component of the market, according to the report, and the source for an estimated one in three teen consumers. While New Jersey and other states restrict sales of these products to minors, recent studies show that most, if not all, under-age buyers did not need to show any identification.
Smyser said researchers did not try to determine who was behind the pro-vaping bots or how effective these messages were in reaching children, who are considered particularly at risk to e-cigarette addiction. National studies show vape use escalated nearly 80% among high school students in 2018 and jumped almost 50% in middle schools; meanwhile, state studies suggest at least one in five high school students in New Jersey used these devices in 2017.
“We have yet to see the equivalent of Joe Camel,” Smyser said, referring to the infamous cartoon camel that critics said was designed to attract young smokers to the cigarette brand. But other studies have shown that using bright colors and sweet flavors are methods of marketing vapes to kids, he noted.
“The focus on youth is disturbing,” said Dr. Arturo Brito, Nicholson’s executive director. “Unless we take action, we are on the way to creating a new generation of nicotine addicts.”
Lawmakers in New Jersey have pledged to ban all vape flavorings — and may also outlaw menthol cigarettes, the only flavor still on the market — and are considering other efforts to help keep these devices out of young hands. Earlier this month, Gov. Phil Murphy released a report from a task force on vape use that called for a flavor ban, among other changes.
The state health department is also working with federal officials to investigate dozens of reports of potential vaping-related lung disease, part of a national review that now includes nearly 1,000 cases. An examination of lung tissue samples from some of these patients, including several who died, revealed damage similar to that caused by chemical warfare, according to doctors at the Mayo Clinic.
Efforts to isolate the specific cause of the vape-related lung disease continue, but most of the cases involve products that were tampered with or bought on the black market. Vaping advocates have highlighted those points and tried to rally support for licensed product dealers, while protesting policies to further limit access to e-cigarettes.
Humans or bots?
The report makes clear it is not always easy to confirm what is a bot and what isn’t. The results are categorized as human, suspected bots, and likely bots. Smyser said some of the bot-like behavior may well involve human beings with strong feelings who then use software tools to automatically distribute their tweets to a wider audience, in a particularly effective way — beyond what an individual could do without computer enhancement.
“There’s just this massive anger and resentment toward this effort to regulate e-cigarettes and vapes,” Smyser said. “There are real people,” he added, “with a lot of righteous indignation.”
Regardless of who is behind the messaging — bots, humans, or a mix — Elnahal said these posts are like misleading political ads and create a disservice to the public. “Either way it is concerning,” he said.