INTRODUCTION There has been a rapid proliferation of synthetic nicotine products in recent years, despite newly established regulatory authority and limited research into its health risks. Previous research has implicated social media platforms as an avenue for nicotine product unregulated sales. Yet, little is known about synthetic nicotine product content on social media. We utilized natural language processing to characterize the sales of synthetic nicotine products on Instagram. METHODS We collected Instagram posts by querying Instagram hashtags (e.g., "#tobaccofreenicotine) related to synthetic nicotine. Using BERT, collected posts were categorized into thematically related topic clusters. Posts within topic clusters relevant to study aims were then manually annotated for variables related to promotion and selling (e.g., cost discussion, contact information for offline sales). RESULTS A total of 7,425 unique posts were collected with 2,219 posts identified as related to promotion and selling of synthetic nicotine products. Nicotine pouches (52.9%, n=1174), ENDS (30.6%, n=679), and flavored e-liquids (14.1%, n=313) were most commonly promoted. 16.1% (n=345) of posts contained embedded hyperlinks and 5.8% (n=129) provided contact information for purported offline transactions. Only 17.6% (n=391) of posts contained synthetic nicotine specific health warnings. CONCLUSIONS In the United States, synthetic nicotine products can only be legally marketed if they have received premarket authorization from the FDA. Despite these prohibitions, Instagram appears to be a hub for potentially unregulated sales of synthetic and "tobacco-free" products. Efforts are needed by platforms and regulators to enhance content moderation and prevent unregulated online sales of existing and emerging synthetic nicotine products. IMPLICATIONS There is limited clinical understanding of synthetic nicotine's unique health risks and how these novel products are changing over time due to regulatory oversight. Despite synthetic nicotine specific regulatory measures, such as the requirement for premarket authorization and FDA warning letters issued to unauthorized sellers, access to and promotion of synthetic nicotine is widely occurring on Instagram, a platform with over 2 billion users and one that is popular among youth and young adults. Activities include direct-to-consumer sales from questionable sources, inadequate health warning disclosure, and exposure with limited age restrictions, all conditions necessary for the sale of various tobacco products. Notably, the number of these Instagram posts increased in response to the announcement of new FDA regulations. In response, more robust online monitoring, content moderation, and proactive enforcement is needed from platforms who should work collaboratively with regulators to identify, report, and remove content in clear violation of platform policies and federal laws. Regulatory implementation and enforcement should prioritize digital platforms as conduits for unregulated access to synthetic nicotine products and other future novel and emerging tobacco products.

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使用自然语言处理识别和表征 Instagram 上合成尼古丁产品的促销和销售。

简介 近年来，尽管新设立了监管机构并且对其健康风险的研究有限，但合成尼古丁产品仍迅速扩散。此前的研究表明社交媒体平台是尼古丁产品不受监管销售的渠道。然而，人们对社交媒体上的合成尼古丁产品内容知之甚少。我们利用自然语言处理来描述 Instagram 上合成尼古丁产品的销售情况。方法 我们通过查询与合成尼古丁相关的 Instagram 主题标签（例如“#tobaccofreenicotine”）来收集 Instagram 帖子。使用 BERT，收集的帖子被分类为主题相关的主题簇。然后，对与研究目标相关的主题簇内的帖子进行手动注释，以获取与研究目标相关的变量。促销和销售（例如，成本讨论、线下销售的联系信息）。 结果 总共收集了 7,425 个独特帖子，其中 2,219 个帖子被确定为与合成尼古丁产品的促销和销售相关。 尼古丁袋（52.9%，n=1174） 、电子烟（ENDS）（30.6%，n=679）和调味电子液体（14.1%，n=313）是最常推广的。16.1%（n=345）的帖子包含嵌入的超链接，5.8%（n=129）提供了据称线下交易的联系信息。只有 17.6% (n=391) 的帖子包含合成尼古丁特定健康警告。结论在美国，合成尼古丁产品只有获得 FDA 的上市前授权才能合法销售。尽管有这些禁令，Instagram 似乎仍然是合成产品和“无烟草”产品可能不受监管的销售中心。平台和监管机构需要努力加强内容审核，防止现有和新兴合成尼古丁产品不受监管的在线销售。影响 对于合成尼古丁独特的健康风险以及这些新产品因监管监督而如何随着时间的推移而发生变化，临床了解有限。尽管针对合成尼古丁采取了具体的监管措施，例如要求上市前授权以及向未经授权的卖家发出 FDA 警告信，但合成尼古丁的获取和推广在 Instagram 这个拥有超过 20 亿用户且深受年轻人欢迎的平台上广泛发生和年轻人。活动包括来自可疑来源的直接面向消费者的销售、健康警语披露不充分、接触年龄限制有限，这些都是销售各种烟草产品所必需的条件。值得注意的是，随着 FDA 新法规的公布，这些 Instagram 帖子的数量有所增加。作为回应，平台需要更强大的在线监控、内容审核和主动执法，平台应与监管机构合作，识别、报告和删除明显违反平台政策和联邦法律的内容。