Protectors or puritans? Responses to media articles about the health effects of e-cigarettes

Background: As the use of e-cigarettes has increased globally, so has the debate about their safety and how they should be regulated. A primary source of information available to the public about the health effects of vaping are media articles, but it is unknown how the public might interpret and use media messaging to form or justify their positions on the regulation of vaping. This study analysed public comments on online media articles to investigate how contested claims about the health effects of e-cigarettes might influence the way people conceptualise the risks and benefits of vaping products, and their opinions on how they should be regulated. Methods: Thematic analysis of 424 online comments on two New York Times articles about vaping. Results: When responding to media articles about the health effects of e-cigarettes, there was significant public debate about what constituted “adequate” evidence on harms. Concerns about the health risks of vaping often centred on pre-existing beliefs about the addictiveness and toxicity of nicotine and “chemicals”, as opposed to scientific information presented in the media article. Claims about conflicts of interests among stakeholders referenced in the media articles were very common. Conclusions: Mixed messages in health communications about e-cigarettes are reflected in public debates. Consistent and accurate messaging about the health effects of nicotine, and the continuum of harm of nicotine products, is needed for people to make informed choices about nicotine products.