Waterpipe Promotion and Use on Instagram: #Hookah
Open Access
- 11 January 2017
- journal article
- research article
- Published by Oxford University Press (OUP) in Nicotine & Tobacco Research
- Vol. 19 (10), 1248-1252
- https://doi.org/10.1093/ntr/ntw329
Abstract
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.Funding Information
- National Cancer Institute (P50CA180905)
- FDA Center for Tobacco Products
This publication has 21 references indexed in Scilit:
- Sex Differences in Hookah-Related Images Posted on Tumblr: A Content Analysis.Journal of Health Communication, 2016
- Social Listening: A Content Analysis of E-Cigarette Discussions on TwitterJournal of Medical Internet Research, 2015
- Hookah-Related Twitter Chatter: A Content AnalysisPreventing Chronic Disease, 2015
- When a ban really is not a ban: internet loopholes and Djarum flavoured cigarettes in the USATobacco Control, 2015
- Waterpipe tobacco smoking legislation and policy enactment: a global analysisTobacco Control, 2014
- Hookah use among college students: Prevalence, drug use, and mental healthDrug and Alcohol Dependence, 2014
- A cross-sectional examination of marketing of electronic cigarettes on TwitterTobacco Control, 2014
- US Health Policy Related to Hookah Tobacco SmokingAmerican Journal of Public Health, 2012
- A Novel Evaluation of World No Tobacco Day in Latin AmericaJournal of Medical Internet Research, 2012
- Daily patterns of conjoint smoking and drinking in college student smokers.Psychology of Addictive Behaviors, 2010