Allem Jon-Patrick, Chu Kar-Hai, Cruz Tess Boley, Unger Jennifer B
Keck School of Medicine, University of Southern California, Los Angeles, CA.
Nicotine Tob Res. 2017 Oct 1;19(10):1248-1252. doi: 10.1093/ntr/ntw329.
Waterpipe (hookah) use is becoming more prevalent in the United States and abroad with potential implications for public health. As waterpipe use rapidly grows in popularity, novel data streams are needed that can help capture and document the social and environmental context in which individuals use, and are marketed, this emerging tobacco product. This study characterized waterpipe-related posts on Instagram in order to inform regulatory and policy activities in the United States.
Data were collected from Instagram, an image-based social media site. Inclusion criteria for this study comprised an Instagram post with the hashtag "#hookah" that was accompanied by geo-location metadata demonstrating that the post was inside the contiguous United States. Rules were established for coding themes of images (n = 1705).
Seven percent of images depicted a single person using a waterpipe and/or blowing smoke, 25% depicted two or more persons lounging and/or using a waterpipe, 6% depicted waterpipes, coals or flavored tobacco without people, 18% of images were promotional material for hookah lounges and restaurant/bars/nightclubs referencing hookah in the text or depicting a waterpipe, 25% were non-waterpipe-related promotional material, 1% were sexually explicit material, and 18% other. 31% of all images depicted or referenced alcohol. 30% of posts provided geo-location from a hookah lounge, 56% from a restaurant/bar/nightclub, and 14% from other types of locations.
The cross promotion of waterpipe and alcohol use by hookah lounges, and restaurants/bars/nightclubs suggests that poly-substance use is regularly depicted, and promoted, in nightlife entertainment as well as normalized on Instagram in the United States.
In the US Instagram posts with the hashtag #hookah regularly depicted waterpipe use in conjunction with alcohol use. Instagram's focus on images facilitates picture-based advertising where hookah lounges promote drink specials at the same time nightclubs promote waterpipe specials. Instagram users often document the variety of shapes, sizes, and styles, of waterpipes, suggesting users take pride in their purchases and like to show their customized, and often times elaborate, waterpipes to their followers. Instagram has been underutilized in understanding tobacco related-behaviors and identifying tobacco-related promotional material.
水烟的使用在美国和其他国家正变得越来越普遍，这对公众健康可能产生影响。随着水烟使用迅速流行起来，需要新的数据流来帮助捕捉和记录个人使用以及推销这种新兴烟草产品的社会和环境背景。本研究对照片墙（Instagram）上与水烟相关的帖子进行了特征分析，以便为美国的监管和政策活动提供信息。
数据收集自基于图像的社交媒体网站照片墙（Instagram）。本研究的纳入标准包括带有“#水烟”标签且附有地理位置元数据的照片墙帖子，该元数据表明帖子发布在美国本土范围内。为图像主题编码制定了规则（n = 1705）。
7%的图像描绘了一个人在使用水烟和/或吸烟，25%的图像描绘了两个或更多人休闲和/或使用水烟，6%的图像描绘了无水烟使用者的水烟、炭火或调味烟草，18%的图像是水烟馆以及在文本中提及水烟或描绘水烟的餐厅/酒吧/夜总会的宣传材料，25%是非水烟相关的宣传材料，1%是色情内容，18%是其他内容。所有图像中有31%描绘或提及了酒精。30%的帖子提供了来自水烟馆的地理位置，56%来自餐厅/酒吧/夜总会，14%来自其他类型的场所。
水烟馆以及餐厅/酒吧/夜总会对水烟和酒精使用的交叉推广表明，在美国，多物质使用在夜生活娱乐中经常被描绘和推广，并且在照片墙（Instagram）上已常态化。
在美国，带有“#水烟”标签的照片墙帖子经常描绘水烟与酒精的共同使用情况。照片墙（Instagram）对图像的关注促进了基于图片的广告宣传，在此过程中，水烟馆在推广水烟特价的同时宣传饮品特价，夜总会也如此。照片墙（Instagram）用户经常记录水烟的各种形状、尺寸和款式，这表明用户对自己购买的水烟感到自豪，并喜欢向关注者展示他们定制的、通常很精致的水烟。在理解烟草相关行为和识别烟草相关宣传材料方面，照片墙（Instagram）一直未得到充分利用。
