Smoking Selfies: Using Instagram to examine smoking behavior

background - Social media has fundamentally changed the way that we receive, create, share and process information.   Increasingly, researchers turn to platforms like Twitter for public health surveillance from flu prediction to disease behavior patterns.  However, our media landscape is constantly evolving and preferences for platforms change.  In 2015,  Instagram, an online photo sharing site, is one of the fastest growing social networks.  According to the Pew Research Center, 53% of young adults (18-29) now use the platform as opposed to 37% for Twitter. 

methods - This first-of-its-kind study will assess the amount and characterize the content of smoking imagery and cigarette brands on Instagram. Data were obtained from Instagram's public API (Application Program Interface) and a private vendor, Ditto Labs, which scans Instagram posts with image recognition software.  Our measures of smoking-related content and tobacco brands were based on user text tags for photos and image recognition software. Over a six-month period from June-December 2014, we used 220 smoking behavior and cigarette brand keywords to collect 4.1 million image posts. 

results - During the study period, tags with "smoke" or "smoking" generated the most photos, at 2,070,851 and 731,910 respectively. Marlboro was the most popular brand, with 100,452 photos, followed by Lucky Strike, with 17,468.  Content of these images was classified as tobacco products, tobacco selfies or smoke clouds.

conclusions - Instagram can be a powerful tool for the surveillance of smoking behavior and social norms among young adults. The popularity of these images may counteract public health efforts to de-normalize smoking.  Further, the sharing of brand images allows tobacco companies covert and unpaid advertising on increasingly popular image-based platforms like Instagram and Tumblr.