Misadventures in Vaping Cessation: A Qualitative Study Demonstrating Social Media as a Highly Utilized Source of Health Advice and Misinformation
A.M. Rusk, A. Ishimoto, C. Varghese, Cassie C. Kennedy · American Journal of Respiratory and Critical Care Medicine · 2025
Abstract Introduction: Over 90% of adolescents (18-24 years) have a social media account. In 2021, an estimated 18.3% of 18-24-year-olds used electronic cigarettes. This age group is more likely to use social media as a health information resource than other sources. The social media platform TikTok is the fastest growing platform among adolescents. There is growing interest in vaping cessation among adolescents, and vaping cessation posts have grown accordingly. Our hypothesis is there are diverse vaping cessation methods described by TikTok users important for clinicians to understand. The use of qualitative methods informed by netnography represents an ideal way to evaluate TikTok videos. Methods: TikTok videos describing at least one vaping cessation method posted in English uploaded after January 1, 2022 were eligible for inclusion. Any post associated with advertising, sponsorship, corporations, or retail entities were excluded. Reposts of any kind were excluded. A total of 200 videos were reviewed in duplicate for eligibility. NVivo Version 14 transcription cloud and coding software was used. Coding was conducted independently by the study team until thematic saturation was reached. This study was deemed exempt by the Mayo Clinic Institutional Review Board as social media data is public domain and no identifiers were collected. Results: A total of 52 videos were included. Included videos had an average of 2.4 million views, 285,000 likes, and 11,000 shares. There were a wide variety of vaping cessation methods described. Some methods, such as hand motions mimicking vaping, limiting exposures, and use of nicotine replacement are supported by cigarette smoking cessation literature. There were also numerous videos outlining methods known to be ineffective or harmful, including instructions to vape continuously until illness occurs, and utilizing negative self-affirmations to “scold” yourself when using electronic cigarettes. Themes of inner strength, motivations, and shame were also discussed, and multiple users described their “wake up call” to quit vaping. Conclusions: Social media platforms are growing in popularity with adolescents and individuals under age 18. The inability for users to discriminate between evidence-based health advice and anecdotal experiences represents a key issue for clinicians to be aware of when counseling patients. Given the age demographics of social media users, this issue will grow as the population ages. Clinicians should engage in conversations with their patients about sources of reputable health information, and future directions may include novel methods such as partnering with influencers or social media companies.