Difficulty Regulating Social Media Content of Age-Restricted Products: Comparing JUUL's Official Twitter Timeline and Social Media Content About JUUL.

Background: In 2018, JUUL Labs Inc, a popular e-cigarette manufacturer, announced it would substantially limit its social media presence in compliance with the Food and Drug Administration's (FDA) call to curb underage e-cigarette use. However, shortly after the announcement, a series of JUUL-related hashtags emerged on various social media platforms, calling the effectiveness of the FDA's regulations into question. Objective: The purpose of this study is to determine whether hashtags remain a common venue to market age-restricted products on social media. Methods: We used Twitter's standard application programming interface to download the 3200 most-recent tweets originating from JUUL Labs Inc's official Twitter Account (@JUULVapor), and a series of tweets (n=28,989) from other Twitter users containing either #JUUL or mentioned JUUL in the tweet text. We ran exploratory (10×10) and iterative Latent Dirichlet Allocation (LDA) topic models to compare @JUULVapor's content versus our hashtag corpus. We qualitatively deliberated topic meanings and substantiated our interpretations with tweets from either corpus. Results: The topic models generated for @JUULVapor's timeline seemingly alluded to compliance with the FDA's call to prohibit marketing of age-restricted products on social media. However, the topic models generated for the hashtag corpus of tweets from other Twitter users contained several references to flavors, vaping paraphernalia, and illicit drugs, which may be appealing to younger audiences. Conclusions: Our findings underscore the complicated nature of social media regulation. Although JUUL Labs Inc seemingly complied with the FDA to limit its social media presence, JUUL and other e-cigarette manufacturers are still discussed openly in social media spaces. Much discourse about JUUL and e-cigarettes is spread via hashtags, which allow messages to reach a wide audience quickly. This suggests that social media regulations on manufacturers cannot prevent e-cigarette users, influencers, or marketers from spreading information about e-cigarette attributes that appeal to the youth, such as flavors. Stricter protocols are needed to regulate discourse about age-restricted products on social media.