Shisha and social media

Shisha and social media: understanding online perceptions of waterpipe smoking Dr Aimee Grant and Hannah O’Mahoney, Institute of Primary Care and Public Health, Cardiff University

Cardiff University Respiratory Bequest Fund

Overview •Use of social media to understand behaviour •Research Design •Data collected •Semiotics (positive/negative/unclassifiable) •Common themes •How can we use these findings to improve public health?

Tobacco use and social media • Social media can provide unique insight into health: timely and large samples (Sloan et al., 2014) •Tobacco companies using Twitter to engage with (potential) customers (Freeman, 2012; Burton et al, 2013)

• BUT, can also be used as a health promotion tool (Hefler et al, 2012; Hamil et al, 2013)

Research design • Aim: to understand how waterpipe smoking is discussed on Twitter • Tweets downloaded using TAGS v5.1*

• 8 hashtags (#): shisha, sheesha, hookah, nargile, narghile, waterpipe, hubblebubble, arghila

• 1 week period in July 2014

• Ramadan • World Cup • Some data collection issues, but all resolved *http://mashe.hawksey.info/2013/02/twitter-archive-tagsv5/

Data collected by # HASHTAG

TOTAL

#HOOKAH

5648

#SHISHA

3032

#NARGILE #SHEESHA #WATERPIPE #HUBBLEBUBBLE

610 253 106 11

#NARGHILE #ARGHILA TOTAL

11 0 9,671

Analysis •Semiotic (Edwards et al., 2013) • Analysis of language to understand if it is positive, negative or neutral • Use of emoticons :) and emojis  🐰 🚬 💨

•Thematic (Braun and Clare, 2006) • Understanding key topics and themes within the textual data

•Documentary analysis (Ferguson, 2006; Ball, 2011) • Understanding key themes within attached photographs

•Nvivo 10 (HO’M) •Validity checks (AG)

Who tweets about waterpipe use? Origin

Number

% of data to be analysed

Unclassifiable User Business

2328 1496 551

52% 34% 12%

Geographical blogger Health agency

30

0.7%

27 7 4439

0.6% 0.2%

Media TOTAL

Data excluded from analysis

Semiotics Semiotic

Number

Percentage

Positive

2229

50% (90% of user tweets)

Living the DREAM :) #atlanticcity #doac #bungalow #hookah #beach #menshealth #actor #bartender #fun… (url).

Negative

64

1.4%

Dating an Arab is gonna have my lungs all kinds of fucked up. #Hookah #Everyday? (url)

Positive and negative

32

0.7%

I wanna glass hookah but they all cost like $300 #nahh #hookah

Unclassifiable

2114

NB: 3646 tweets contained urls

48%

Themes: consumption with… •Other people – 432 (25% of user tweets) • Wednesday Funday with the girls ✌️😜 #manisandpedis #dinner #vapianos #drinks #hookah #crave

•Alcohol – 338 (27% of premises tweets) • #NOW !!!!! #NiceWeather #DC #Lima #PushHappyHour #Sushi #Hookah #Cocktails #Tapas & $10 Valet… (url)

•Food – 170 (20% of premises tweets)

• Last night was too sick #Hookah #Food #Friends 👍(url)

•Non-alcoholic drinks -63 • After a crazy huge Persian dinner nothing is better then #hookah and tea #lastnight #latertweet (url)

• Drugs (cannabis) -41 • my crib den turned into the #hookah spot for my friends and i but i don't care...as long as they provide the flava an the weed :)

Themes: associated activities •Football-120 • This game is getting me crazy😧 smoking #Hookah watching the game come on #ARG #TeamArgentina 😀😀💙💚

•Party – 113 • #Hookah!!! #DayParty #ATL @ Prive Nightclub (url)

•Music – 107 (13% of premesis) • #exoticsundays is place to be right now #ultra bad ass #dj #hookah #music #dancing going crazy fuck… (url)

•Watching TV -31 • Finally get to just relax #Hookah #Food #Netflix #Tired

Themes: other •Friends -251 •Health risks – 227 •Smoke/ smoke rings – 150 •Emotions: love - 108; happy -42 •Public Health messages – 31 •Partner/boyfriend/girlfriend - 22 •Addiction – 21 •Smoking alone - 12

Conclusions • The dominant voice is that of users • Lack of public health use of Twitter (worldwide) • Businesses promote their venues as places to use waterpipe alongside food and alcohol • Overall high level of ‘positive’ tweets, lack of reporting of health risks • Thematic analysis shows waterpipe smoking as a sociable and enjoyable activity • Need for further research: tobacco and social media content, and how it can be used in public health interventions