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Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 33643

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Special Issue Editors

Dr. Janni Leung

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Guest Editor

School of Public Health, The University of Queensland, Brisbane, QLD 4072, Australia
Interests: epidemiology; meta-analysis; cross-sectional studies; longitudinal studies; burden of disease; addiction; mental health

Dr. Gary Chan

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Guest Editor

National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD 4072, Australia
Interests: substance use; alcohol; cannabis

Special Issue Information

Dear Colleagues,

We are calling for papers for a Special Issue titled “Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media” in the International Journal of Environmental Research and Public Health.

Harmful products, like tobacco, e-cigarettes, alcohol, and other substances, are increasingly promoted and portrayed on social media platforms. In doing so, not only are industries subverting many existing legislations that ban the advertising of these products in a number of countries, but they are also largely targeting vulnerable populations, including children and adolescents, exposed to this contents on social media.

This Special Issue will explore how industries, like the tobacco industry, promote their products online, and will aim to better understand the strategies that are employed. It will also explore how tobacco, e-cigarettes, alcohol, and other substances are portrayed online, and the implications of how this content may have an impact on the populations exposed to it. The Special Issue will also examine possible regulation models to limit exposure to this form of marketing and influence. Opportunities to use social media to develop innovative interventions and to advance public health measures that aim to control harmful products, and the impact of commercial interests are also discussed, and future research possibilities will be proposed

Topics of interest include, but are not limited to, the following:

Studies involving quantitative or qualitative approaches to exploring social media influences on attitudes and behaviors related to tobacco, e-cigarettes, alcohol, and other substance use in the populations exposed.
Promotions and intervention (especially prevention and policy) studies incorporating social media so as to reduce the potential harm of online exposure to substance use content.

We would like to invite papers related to these topics for this Special Issue, which we hope will discuss the public health implications of the increasing tobacco, alcohol, and other substances related content on social media.

Dr. Janni Leung
Dr. Gary Chan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

data science
health informatics
health promotion
health policy
public health
social media
social media intervention

Published Papers (12 papers)

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Research

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10 pages, 335 KiB

Open AccessArticle

Promotion of E-Cigarettes on TikTok and Regulatory Considerations

by Jonine Jancey, Tama Leaver, Katharina Wolf, Becky Freeman, Kevin Chai, Stella Bialous, Marilyn Bromberg, Phoebe Adams, Meghan Mcleod, Renee N. Carey and Kahlia McCausland

Int. J. Environ. Res. Public Health 2023, 20(10), 5761; https://doi.org/10.3390/ijerph20105761 - 09 May 2023

Cited by 2 | Viewed by 4955

Abstract

E-cigarettes are promoted extensively on TikTok and other social media platforms. Platform policies to restrict e-cigarette promotion seem insufficient and are poorly enforced. This paper aims to understand how e-cigarettes are being promoted on TikTok and provide insights into the effectiveness of current TikTok policies. Seven popular hashtag-based keywords were used to identify TikTok accounts and associated videos related to e-cigarettes. Posts were independently coded by two trained coders. Collectively, the 264 videos received 2,470,373 views, 166,462 likes and 3426 comments. The overwhelming majority of videos (97.7%) portrayed e-cigarettes positively, and these posts received 98.7% of the total views and 98.2% of the total likes. A total of 69 posts (26.1%) clearly violated TikTok’s own content policy. The findings of the current study suggest that a variety of predominantly pro-vaping content is available on TikTok. Current policies and moderation processes appear to be insufficient in restricting the spread of pro-e-cigarette content on TikTok, putting predominantly young users at potential risk of e-cigarette use. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

11 pages, 1055 KiB

Open AccessArticle

Public Perceptions of Flavored Waterpipe Smoking on Twitter

by Juan Ramon Feliciano, Dongmei Li and Zidian Xie

Int. J. Environ. Res. Public Health 2023, 20(7), 5264; https://doi.org/10.3390/ijerph20075264 - 27 Mar 2023

Viewed by 1344

Abstract

Waterpipe tobacco smoking has become increasingly popular in recent years, especially among youth. We aimed to understand longitudinal trends in the prevalence and user perception of waterpipes and their flavors on Twitter. We extracted waterpipe-related tweets from March 2021 to May 2022 using the Twitter Streaming API and classified them into promotional tweets and non-promotional tweets. We examined the longitudinal trends regarding the waterpipe flavors mentioned on Twitter and conducted sentiment analysis on each waterpipe flavor-related non-promotional tweet. Among over 1.3 million waterpipe-related tweets, 1,158,884 tweets were classified as non-promotional and 235,132 were classified as promotional. The most frequently mentioned waterpipe flavor groups were fruit (34%), sweets (17%), and beverages (15%) among all flavor-containing non-promotional tweets (17,746 tweets). The least mentioned flavor groups were tobacco (unflavored, 4%) and spices (2%). Sentiment analysis showed that among non-promotional waterpipe-related tweets, 39% were neutral, 36% were positive, and 23% were negative. The most preferred waterpipe flavors were fruit, mixed, and alcohol flavors. The least preferred flavor groups were tobacco and spice flavors. Our study provided valuable information on the prevalence of waterpipe flavors that can be used to support the future regulation of flavored waterpipe tobacco products given the nature of the current regulations on other flavored tobacco products. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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12 pages, 338 KiB

Open AccessArticle

A Comparative Analysis of E-Cigarette and Cigarette Posts on Instagram

by Young-shin Lim and Ji Young Lee

Int. J. Environ. Res. Public Health 2023, 20(4), 3116; https://doi.org/10.3390/ijerph20043116 - 10 Feb 2023

Cited by 2 | Viewed by 1660

Abstract

E-cigarette use has grown rapidly over the past decade and become a threat to public health. Marketing—especially through social media—has contributed significantly to this growth, which suggests that regulating content in social media will be critical in supporting efforts to reverse this trend. A content analysis was performed to compare 254 e-cigarette posts on Instagram with 228 cigarette posts on the same platform. The majority of e-cigarette posts were from e-cigarette companies (40.9%) and industry people (18.5%), whereas the majority of cigarette posts were from laypeople (76.8%). More e-cigarette posts than cigarette posts appeared to have a marketing intent (56.3% vs. 1.3%), and brand representation in photographs/videos was more frequent in the e-cigarette posts than in the cigarette posts (63.0% vs. 15.8%). Further, compared with the e-cigarette posts, the cigarette posts were more likely to portray daily life (73.2% vs. 41.3%) and humans (80.3% vs. 43.7%) in the photograph/video. The cigarette posts also portrayed smoking much more often than the e-cigarette posts portrayed vaping (67.1% vs. 21.3%). The study findings broaden the field’s understanding of cigarette and e-cigarette content on Instagram and social media, and have implications for monitoring and regulating content for e-cigarettes and cigarettes. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

10 pages, 1633 KiB

Open AccessArticle

Public Perceptions on the Policy of Electronic Cigarettes as Medical Products on Twitter

by Xubin Lou, Pinxin Liu, Zidian Xie and Dongmei Li

Int. J. Environ. Res. Public Health 2023, 20(3), 2618; https://doi.org/10.3390/ijerph20032618 - 01 Feb 2023

Cited by 2 | Viewed by 1836

Abstract

Starting from 1 October 2021, Australia requires a prescription for purchasing nicotine vaping products. On 29 October 2021, the UK provided a guideline to treat e-cigarettes as medical products. This study aims to understand public perceptions of the prescription policy in Australia and the UK on Twitter. Tweets related to e-cigarettes from 20 September 2021 to 31 December 2021 were collected through Twitter streaming API. We adopted both a human and machine learning model to identify a total of 1795 tweets from the UK and Australia related to the prescription policy. We classified them into pro-policy, anti-policy, and neutral-to-policy groups, and further characterized tweets into different topics. Compared to Australia, the proportion of pro-policy tweets in the UK was significantly higher (19.43% vs. 10.92%, p < 0.001), while the proportion of anti-policy tweets was significantly lower (43.4% vs. 50.09%, p = 0.003). The main topics for different attitudes towards the prescription policy between the two countries showed some significant differences, for example, “help quit smoking” in the UK and “health effect of e-cigarettes” in Australia for the positive attitude, “economic effect” in the UK and “preventing smoking cessation” in Australia for the negative attitude, which reflected different public concerns. The findings might provide valuable guidance for other countries to implement a similar policy in the future. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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12 pages, 3393 KiB

Open AccessArticle

E-Cigarette Retailers’ Use of Instagram in New Zealand: A Content Analysis

by Lucy Hardie, Judith McCool and Becky Freeman

Int. J. Environ. Res. Public Health 2023, 20(3), 1897; https://doi.org/10.3390/ijerph20031897 - 19 Jan 2023

Cited by 4 | Viewed by 2225

Abstract

E-cigarette companies claim their products are key to improving health outcomes by providing smokers with lower-risk alternatives. However, the rapid uptake of e-cigarettes among young people has prompted concern about company marketing practices. In 2019, there was no legislation to govern e-cigarette marketing in New Zealand. This period provides an ideal context for examining how e-cigarette companies promoted their products before the introduction of marketing regulations. We conducted a content analysis of the Instagram accounts of five prominent e-cigarette retailers based in New Zealand during 2019–2020. We assessed health- and risk-related claims and marketing techniques. Less than 10% of Instagram posts refer to smoking alternatives or risk of nicotine addiction. E-cigarette devices were more likely to be promoted for stylistic features such as colours and ease of use (29.7%). Music festival sponsorship (19.1%), social media influencers (9.2%), and lifestyle marketing (41.5%) were identified as youth-oriented promotional strategies. E-cigarette retailers claim to promote harm-reduction tools to smokers, yet this study finds few references to smoking alternatives in any content. Instead, retailers utilised strategies to engage with a young audience, including festival sponsorship and stylish influencers. This youth-oriented marketing, in combination with weak and delayed government action, may have contributed to the high use of e-cigarettes among young New Zealanders. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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14 pages, 2044 KiB

Open AccessArticle

Expanding the E-Liquid Flavor Wheel: Classification of Emerging E-Liquid Flavors in Online Vape Shops

by Shaoying Ma, Zefeng Qiu, Qian Yang, John F. P. Bridges, Jian Chen and Ce Shang

Int. J. Environ. Res. Public Health 2022, 19(21), 13953; https://doi.org/10.3390/ijerph192113953 - 27 Oct 2022

Cited by 9 | Viewed by 2322

Abstract

Introduction: Electronic cigarettes are the most popular tobacco product among U.S. youth, and over 80% of current youth users of e-cigarettes use flavored e-cigarettes, with fruit, mint/menthol, and candy/sweets being the most popular flavors. A number of new e-liquid flavors are currently emerging in the online e-cigarette market. Menthol and other flavored e-cigarettes could incentivize combustible tobacco smokers to transition to e-cigarette use. Methods: From February to May 2021, we scraped data of over 14,000 e-liquid products, including detailed descriptions of their flavors, from five national online vape shops. Building upon the existing e-liquid flavor wheel, we expanded the semantic databases (i.e., key terms) to identify flavors using WordNet—a major database for keyword matching and group discussion. Using the enriched databases, we classified 14,000+ e-liquid products into the following 11 main flavor categories: “fruit”, “dessert/candy/sweets”, “coffee/tea”, “alcohol”, “other beverages”, “tobacco”, “mint/menthol”, “nuts”, “spices/pepper”, “other flavors”, and “unspecified flavor”. Results: We find that the most prominent flavor sold in the five online vape shop in 2021 was fruit flavored products, followed by dessert/candy/other sweets. Online vendors often label a product with several flavor profiles, such as fruit and menthol. Conclusions: Given that online stores market products with multiple flavor profiles and most of their products contain fruit flavor, the FDA may have issued marketing denial orders to some of these products. It is important to further examine how online stores respond to the FDA flavor restrictions (e.g., compliance or non-compliance). Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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14 pages, 378 KiB

Open AccessArticle

Smokers’ Engagement Behavior on Facebook: Verbalizing and Visual Expressing the Smoking Cessation Process

by Jezdancher Watti, Máté Millner, Kata Siklósi, Hedvig Kiss, Oguz Kelemen and Dávid Pócs

Int. J. Environ. Res. Public Health 2022, 19(16), 9983; https://doi.org/10.3390/ijerph19169983 - 12 Aug 2022

Viewed by 1190

Abstract

The “processes of change” and “motivational language” are common in smoker Facebook users’ comments under smoking cessation support contents. Smokers can combine this verbalization of the smoking cessation process with visual expression when they use comments and Facebook reactions at the same time. The aim of this study was to understand the relationship between processes of change, motivational language, and the Facebook reaction buttons. A total of 821 smokers’ comments were analyzed in the current study (n = 821), which responded to image-based smoking cessation support contents. The processes of change and the motivational language used in the investigated comments were identified. These linguistic categories were compared with the usage of reaction buttons. The Facebook users who used the “Haha” reaction button wrote a significantly higher proportion of sustain talk than those who used the “Like” or “Love” reaction buttons. The Facebook users who combined the comment and “Love” reaction wrote significantly more change talk than those who did not utilize these buttons. We suggest that the “Haha” reaction may be a negative indicator, the “Like” reaction may be a neutral indicator, and the “Love” reaction may be a positive engagement indicator in terms of the smoking cessation process during Facebook-based interventions. These results may highlight how to evaluate Facebook reactions relating to smoking cessation support contents. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

13 pages, 2944 KiB

Open AccessArticle

Price Promotions of E-Liquid Products Sold in Online Stores

by Shaoying Ma, Shuning Jiang, Meng Ling, Jian Chen and Ce Shang

Int. J. Environ. Res. Public Health 2022, 19(14), 8870; https://doi.org/10.3390/ijerph19148870 - 21 Jul 2022

Cited by 5 | Viewed by 1659

Abstract

Background: Retailer price promotions are an important marketing strategy to attract consumers. However, there is scarce evidence on how retail price promotions are being implemented by e-cigarette online stores, particularly for e-liquid products that are not often found in brick-and-mortar stores and sold in lower prices compared to other types of e-cigarettes. Objectives: We collect data on e-liquid price-promotion activities from online stores using web scraping. From February to May 2021, we scraped the price promotion data of over 14,000 e-liquid products, from five popular online vape shops that sell nationwide in the US. We present descriptive analyses of price promotion on those products, assess price promotion practices in online stores, and discuss components of the final purchase price paid by online customers. Findings: Of the 14,000 e-liquid products and over, 13,326 (92.36%) were on sale, and each online store on average offered discounts from 9.20% to 47.53% for these products. The distribution of the after-discount price was largely similar across the five stores, and there is evidence that each store had adopted different price-promotion strategies. Conclusion: Despite low prices, price promotions are common for e-liquid products, which may undermine the effect of e-cigarette pricing policies such as excise tax that are designed to raise e-cigarette prices. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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11 pages, 2071 KiB

Open AccessArticle

An Investigation of Influential Users in the Promotion and Marketing of Heated Tobacco Products on Instagram: A Social Network Analysis

by Jiayan Gu, Lorien C. Abroms, David A. Broniatowski and W. Douglas Evans

Int. J. Environ. Res. Public Health 2022, 19(3), 1686; https://doi.org/10.3390/ijerph19031686 - 01 Feb 2022

Cited by 10 | Viewed by 3079

Abstract

While an increasing body of the literature has documented the exposure to emerging tobacco products including heated tobacco products (HTPs) on social media, few studies have investigated the various stakeholders involved in the generation of promotional tobacco content. This study constructed a social network of Instagram users who posted IQOS content, a leading HTP brand, between 1 January and 5 April 2021 and identified users who positioned near the center of the network. We identified 4526 unique Instagram users who had created 19,951 IQOS-related posts during the study period. Nearly half of the users (42.1%) were business accounts authorized by Instagram, among which 59.0% belonged to Personal Goods and General Merchandise Stores and 18.1% belonged to Creators and Celebrities. For users with higher in-degree, out-degree, betweenness, and closeness centrality in the network, the majority of them were accounts directly associated with IQOS (e.g., containing “iqos” in username) or related to tobacco business as self-identified in the bio. Our findings further refine the social media marketing presence of tobacco products and suggest that the current self-regulatory efforts led by social media platforms are far from enough. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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9 pages, 582 KiB

Open AccessFeature PaperArticle

Changes in Viewer Engagement and Accessibility of Popular Vaping Videos on TikTok: A 12-Month Prospective Study

by Brienna N. Rutherford, Tianze Sun, Carmen C. W. Lim, Jack Chung, Brandon Cheng, Lily Davidson, Calvert Tisdale, Janni Leung, Daniel Stjepanović, Jason P. Connor and Gary C. K. Chan

Int. J. Environ. Res. Public Health 2022, 19(3), 1141; https://doi.org/10.3390/ijerph19031141 - 20 Jan 2022

Cited by 12 | Viewed by 5306

Abstract

Aim: There are concerns regarding what young people are exposed to on TikTok due to trending content promoting e-cigarette use through humour, marketing and lifestyle acceptability. Using baseline data from November 2020, we aimed to examine how much content from a sample of popular vaping videos remained accessible at 9- and 12-month follow-ups. We aimed to monitor changes in viewer engagement (using metadata) before and after the U.S. Congressional Hearing on youth protection measures on social media in October 2021. Methods: Hashtag-based keywords were used to collect the most viewed publicly available e-cigarette related videos on TikTok (N = 802) from inception to November 2020 to form a baseline. Researchers conducted a longitudinal descriptive study using this data, with 9- and 12-month follow-ups to measure changes in viewer engagement (using metadata) and content availability. Findings: Of the 802 videos from the baseline, 562 remained at the 9-month follow-up and 511 remained at the 12-month follow-up. At the 12-month follow-up, the majority of vaping-related hashtags were removed by TikTok after the Congressional Hearing. Between the baseline and 9-month follow up, views increased by 1.4% and likes increased by 4.4%. At 12-month follow-up, views had increased by 1.7% and likes by 4.2% compared to baseline data. Whilst 291 videos were no longer publicly accessible at 12-month follow-up, 39 of these were made inaccessible by the content creators. The most viewed and most liked vaping videos at baseline were still publicly available. Conclusions: Whilst the depiction type and thematic distribution of removed videos suggest that TikTok may be removing a small proportion of content that promotes the use of e-cigarettes, metadata of remaining videos indicate an increase in viewer engagement. TikTok’s removal of explicit substance-related hashtags from the platform could be a step towards preventing adolescents from being exposed to harmful behaviours and substances online. However, the platform should consider enforcing effective age restrictions on content that promotes substance use in a positive light. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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13 pages, 2056 KiB

Open AccessArticle

Emotional Responses and Perceived Relative Harm Mediate the Effect of Exposure to Misinformation about E-Cigarettes on Twitter and Intention to Purchase E-Cigarettes among Adult Smokers

by Jessica Liu, Caroline Wright, Olga Elizarova, Jennifer Dahne, Jiang Bian and Andy S. L. Tan

Int. J. Environ. Res. Public Health 2021, 18(23), 12347; https://doi.org/10.3390/ijerph182312347 - 24 Nov 2021

Cited by 4 | Viewed by 2307

Abstract

There is a gap in knowledge on the affective mechanisms underlying effects of exposure to health misinformation. This study aimed to understand whether discrete emotional responses and perceived relative harm of e-cigarettes versus smoking mediate the effect of exposure to tweets about the harms of e-cigarettes on Twitter and intention to purchase e-cigarettes among adult smokers. We conducted a web-based experiment in November 2019 among 2400 adult smokers who were randomly assigned to view one of four conditions of tweets containing different levels of misinformation. We fitted mediation models using structural equation modeling and bootstrap procedures to assess the indirect effects of exposure to tweets through perceived relative harm of e-cigarettes and six discrete emotions. Our findings support that exposure to tweets about harms of e-cigarettes influence intention to purchase e-cigarettes through perceived relative harm, discrete emotional responses, and serially through emotional responses and perceived relative harm. Feeling worried, hopeful, and happy mediated the effects of condition on intention to purchase e-cigarettes. Feeling scared, worried, angry, and hopeful mediated the effects serially through perceived relative harm. Affective responses and perceived relative harm following exposure to misinformation about e-cigarette harm may mediate the relationship with intention to purchase e-cigarettes among adult smokers. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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Other

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15 pages, 2372 KiB

Open AccessSystematic Review

A Systematic Review of E-Cigarette Marketing Communication: Messages, Communication Channels, and Strategies

by Joanne Chen Lyu, Peiyi Huang, Nan Jiang and Pamela M. Ling

Int. J. Environ. Res. Public Health 2022, 19(15), 9263; https://doi.org/10.3390/ijerph19159263 - 28 Jul 2022

Cited by 12 | Viewed by 4191

Abstract

Marketing plays a key role in increasing the popularity of e-cigarettes. We conducted a systematic review of the existing literature published between 2003 and 2019 in eight databases to describe e-cigarette marketing communication messages by communication channels and marketing communication strategies. Forty-one articles were included in the analysis after screening. Ten key messages were identified. Cessation and health-related benefits (each n = 31, 75.6%) were the most reported marketing communication messages, followed by sociability/lifestyle and use experience. The Internet (n = 32, 78.0%) was the most studied communication channel compared to print, TV/movie/radio, and point-of-sales (POS)/retail stores. The most studied marketing communication strategies were advertising (n = 28, 68.3%), followed by public relations and sales promotion. Published research studies reported consistent messages about e-cigarettes across communication channels and marketing communication strategies. Claims of smoking cessation and health-related benefits were widely identified in the existing literature. While therapeutic claims are prohibited, soft sell messages, such as social appeals, for which regulatory reach may be limited, may require educational campaigns. Internet marketing has attracted much attention, with limited studies on messages in print, TV/movie/radio, and POS/retail stores. The lack of studies of direct marketing messaging indicates a big gap between industry spending and academic research; more studies of messaging utilizing this strategy are needed. Full article

(This article belongs to the Special Issue Public Health Impacts of Exposure to Tobacco, Alcohol, and Other Substances Content on Social Media)

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