Portrayal of electronic cigarettes on YouTube

Background: As the most popular video sharing website in the world, YouTube has the potential to reach and influence a huge audience. This study aims to gain a systematic understanding of what e-cigarette messages people are being exposed to on YouTube by assessing the quantity, portrayal and reach of e-cigarette videos. Methods: Researchers identified the top 20 search results on YouTube by relevance and view count for the following search terms: electronic cigarettes, e-cigarettes, ecigarettes, ecigs, smoking electronic cigarettes, smoking e-cigarettes, smoking ecigarettes, smoking ecigs. A sample of 196 unique videos was coded for overall portrayal and genre. Main topics covered in e-cigarette videos were recorded and video statistics and viewer demographic information were documented. Results: Among the 196 unique videos, 94% (n = 185) were pro to e-cigarettes and 4% (n = 8) were neutral, while there were only 2% (n = 3) that were anti to e-cigarettes. The top 3 most prevalent genres of videos were advertisement, user sharing and product review. 84.3% of pro videos contained Web links for e-cigarette purchase. 71.4% of pro videos claimed that e-cigarettes were healthier than conventional cigarettes. Audience was primarily from the United States, the United Kingdom and Canada and pro e-cigarette videos were watched more frequently and rated much more favorably than anti ones. Conclusions: The vast majority of information on YouTube about e-cigarettes promoted their use and depicted the use of e-cigarettes as socially acceptable. It is critical to develop appropriate health campaigns to inform e-cigarette consumers of potential harms associated with e-cigarette use.