Spanish-Language Tobacco-Related Posts on Twitter: Content Analysis

Abstract Introduction Twitter data have been used to surveil public sentiment about tobacco products; however, most tobacco-related Twitter research has been conducted with English-language posts. There is a gap in the literature on tobacco-related discussions on Twitter in languages other than English. This study summarized tobacco-related discussions in Spanish on Twitter. Methods A set of Spanish terms reflecting electronic cigarettes (eg, "cigarillos electrónicos"), cigarettes (eg, “pitillo”), and cigars (eg, “cigaro”) were identified. A content analysis of tweets (n = 1352) drawn from 2021 was performed to examine themes and sentiment. An initial codebook was developed in English then translated to Spanish and then translated back to English by a bilingual (Spanish and English) member of the research team. Two bilingual members of the research team coded the tweets into themes and sentiment. Results Themes in the tweets included (1) product promotion (n = 168, 12.4%), (2) health warnings (n = 161, 11.9%), (3) tobacco use (n = 136, 10.1%), (4) health benefits of vaping (n = 58, 4.3%), (5) cannabis use (n = 50, 3.7%), (6) cessation (n = 47, 3.5%), (7) addiction (n = 33, 2.4%), (8) policy (n = 27, 2.0%), and (9) polysubstance use (n = 12, 0.9%). Neutral (n = 955, 70.6%) was the most common category of sentiment observed in the data. Conclusions Tobacco products are discussed in multiple languages on Twitter and can be summarized by bilingual research teams. Future research should determine if Spanish-speaking individuals are frequently exposed to pro-tobacco content on social media and if such exposure increases susceptibility to use tobacco among never users or sustained use among current users. Implications Spanish-language pro-tobacco content exists on Twitter, which has implications for Spanish-speaking individuals who may be exposed to this content. Spanish-language pro-tobacco-related posts may help normalize tobacco use among Spanish-speaking populations. As a result, anti-tobacco tweets in Spanish may be necessary to counter areas of the online environment that can be considered pro-tobacco.