Online misinformation on e-cigarette use and the potential of digital public health interventions

Abstract The tobacco industry introduced electronic cigarettes (e-cigarettes) as a supposed measure for harm reduction or cessation strategy among conventional cigarette smokers. Nevertheless, public health has raised awareness about the risks that e-cigarettes pose for population health, including cardiovascular and respiratory problems and possible nicotine dependence. According to the World Health Organization, the prevalence of e-cigarettes among adolescents has increased after the COVID-19 pandemic, showing a significant health threat for European countries, such as Austria (12%), Germany (15%), and Spain (10%). Additionally, several studies show that users of internet and social media platforms, such as X (formerly Twitter), Instagram, and YouTube, are exposed to positive content about vaping, marketing, and promotion of e-cigarette products, and a lack of public health communication about their consequences. At the same time, evidence suggests that more than 50% of European adults look for health-related information online, which poses significant difficulties for digital public health strategies aimed at mitigating e-cigarette misinformation and online smoking prevention. Researchers and practitioners should adopt a holistic approach when designing, implementing, and evaluating digital interventions, including the sociodemographic characteristics of the targeted population, community-engaged and participatory research design frameworks focused on countering misinformation for fact-checking and debunking misinformation, but also incorporate preventive interventions based on psychological inoculation and media literacy skills for increasing recognition of misinformation messages of e-cigarettes and vaping products.