Public perceptions and discussions of synthetic nicotine on Twitter.

Background: As alternative replacement products for tobacco-derived nicotine, synthetic nicotine products have recently emerged and gained increasing popularity. This study analyzes public perception and discussion of synthetic nicotine products on Twitter (now "X"). Methods: Through Twitter streaming API (Application Programming Interface), we have collected 2,764 Twitter posts related to synthetic nicotine from December 12, 2021, to October 17, 2022, using keywords related to synthetic nicotine. By applying an inductive approach, two research assistants manually determined the relevance of tweets to synthetic nicotine products and assessed the attitude of tweets as positive, negative, and neutral of tweets toward synthetic nicotine, and the main topics. Results: Among 1,007 tweets related to synthetic nicotine products, the proportion of negative tweets (383/1007, 38.03%) toward synthetic nicotine products was significantly higher than that of positive tweets (218/1007, 21.65%) with a p-value <0.05. Among negative tweets, major topics include the concern about addiction and health risks of synthetic nicotine products (44.91%) and synthetic nicotine as a policy loophole (31.85%). Among positive tweets, top topics include alternative replacement for nicotine (39.91%) and reduced health risks (31.19%). Conclusion: There are mixed attitudes toward synthetic nicotine products on Twitter, resulting from different perspectives. Future research could incorporate demographic information to understand the attitudes of various population groups.