Twitter Discourse on Nicotine as Potential Prophylactic or Therapeutic for COVID-19

Objective: The low observed prevalence of smokers among hospitalized COVID-19 patients in certain cohorts has led to a hypothesis regarding nicotine9s therapeutic role in COVID-19 prevention and treatment. As new scientific evidence surfaces, premature conclusions about nicotine are rife in social media, especially unwarranted leaps of such associations to vaping and smoking. This study reports on the prevalence of such leaps and the nature of authors who are making them. Methods: We used a Twitter API subscription service to download tweets (n = 17,533) that match terms indicating nicotine or vaping themes, in addition to those that point to a prophylactic or therapeutic effect and COVID-19 (January-July 2020). Using a windowing approach, we focused on tweets that are more likely to convey the therapeutic intent. We hand-annotated these filtered tweets and built a classifier that identifies tweets that extrapolate a nicotine link to vaping/smoking. We analyzed the frequently used terms in author bios, top Web links, and hashtags of such tweets. Results: 21% of our filtered tweets indicate a vaping/smoking-based prevention/treatment narrative. Our classifier was able to spot tweets that make unproven claims about vaping/smoking and COVID-19 with a positive predictive value of 85%. Qualitative analyses show a variety of ways therapeutic claims are being made and user bios reveal pre-existing notions of positive stances toward vaping. Conclusion: The social media landscape is a double-edged sword in tobacco communication. Although it increases information reach, consumers can also be subject to confirmation bias when exposed to inadvertent or deliberate framing of scientific discourse that may border on misinformation. This calls for circumspection and additional planning in countering such narratives as the COVID-19 pandemic continues to ravage our world.