Positive portrayals of e-cigarettes and vaping are freely available without any age restrictions on TikTok, with the top 800 viewed videos garnering over 1 billion views, according to research published online in Tobacco Control.

Tighter regulations are needed to curb teens’ potential exposure to these videos, given the popularity of the platform with this age group, researchers from The University of Queensland (Australia) said.

TikTok is the fastest growing platform worldwide, attracting 800 million monthly users who spend an average of 52 minutes on it and watch more than 200 videos a day, say the researchers. A third of its users in the USA are aged 14 or younger.

TikTok’s community guidelines restrict uploading videos featuring “the depiction, promotion, or trade of drugs or other controlled substances,” researchers report, adding that advertising of tobacco and alcohol products is also banned on the platform.

Given TikTok’s increasing popularity among teens, the researchers wanted to see how videos featuring e-cigarettes and vaping were portrayed on the platform. They identified the most popular vaping hashtags based on the number of views on one day in November 2020: ‘#vape’, ‘#vapetricks’, ‘#juulgang’, ‘#puffbar’, ‘#nicotine’, ‘#vapenation’, ‘#vaping’, ‘#vapeshop’, and ‘#vapelife’. And they collected publicly available URL links for the most popular vaping-related videos (1000) from the inception of TikTok (earliest upload date January 2019) to November 2020.

The numbers of views, likes, user categories and themes were then independently reviewed. After removing duplicates and videos unrelated to vaping, despite their hashtag, the final sample contained 808 videos. Collectively, these videos were viewed over 1.5 billion times, with an average view count of 1,000,000 (range 112,900-78, 600,000) and an average ‘likes’ count of 143,000 (range 10, 000-1,000,000).

Nearly two-thirds of these videos portrayed e-cigarette use positively (63%), and these were collectively viewed over 1.1 billion times. Neutral depictions of e-cigarette use were viewed a total of 290 million times (24%) while negative depictions were viewed a total of 193 million times (13%).

Seven principal themes emerged:

  • ‘comedy and joke’ (52%; 618 million total views),
  • ‘lifestyle and acceptability’ (35%; 459 million views),
  • ‘marketing’ (29%; 392 million views),
  • ‘vaping tricks’ (20%; 487 million views),
  • ‘nicotine and addiction’ (20%; 194 million views),
  • ‘creativity’ or how to tutorials (16%; 322 million views) and
  • ‘warning’ (11%; 131 million views).

Videos categorized as ‘comedy and joke’ were most common (421/808; 52%), followed by ‘lifestyle and acceptability’ (282/808; 35%), ‘marketing’ (230/808; 28.5%), ‘vaping tricks’ (160/808; 20%), ‘nicotine and addiction’ (159/808; 20%), ‘creativity and tips’ (130/808; 16%) and ‘warning’ (86/808; 10%). The people in the videos were perceived to be 71% male and 26% appeared to be under 18.

This is an observational study, and therefore can’t establish causality. The researchers acknowledge that their sample didn’t capture videos that used emoticons or those that don’t caption their postings with hashtags. Nor are the findings able to determine the outcome of exposure to e-cigarette content.

But they point out that “experimental and longitudinal data suggest that viewing other young people, friends, acquaintances or influencers vaping in fun and entertaining contexts, is likely to normalize e-cigarette use and make it a behavior to emulate.”

And they conclude: “Previous studies have indicated that exposure to vaping related content among youth is associated with e-cigarette use. Considering vaping-related videos are widely accessible on TikTok, there is an urgent need to consider age restrictions to reduce youth uptake.”