Exploring online communication about cigarette smoking among Twitter users who self-identify as having schizophrenia

“This systematic process enabled continuous verification of the coding, and has demonstrated utility for achieving reliability and validity in qualitative data collection and analysis (Morse et al., 2002).”

“Smoking has a profound impact on mortality and quality of life (Centers for Disease Control and Prevention, 2005; Stewart et al., 2009), and elevated rates of cigarette smoking contribute to dramatically reduced life expectancy among individuals with schizophrenia (Walker et al., 2015).”

“Introduction Numerous studies have documented the strong association between schizophrenia spectrum disorders and tobacco use, whereby people with schizophrenia smoke cigarettes at substantially higher rates compared with the general population (de Leon and Diaz, 2005; Lohr and Flynn, 1992).”

“…are highly active on social media and use platforms like Facebook or Twitter at comparable rates as the general population (Birnbaum et al., 2015; Naslund et al., 2016a), highlighting the potential to use social media to reach and offer treatments to people with schizophrenia (Torous and…”

“Persons with schizophrenia are often subjected to high levels of interpersonal stigma (Brohan et al., 2010; Lee et al., 2005), which can interfere with social functioning and can lead to increased risk of social isolation and withdrawal (Staring et al.”

“Smoking has a profound impact on mortality and quality of life (Centers for Disease Control and Prevention, 2005; Stewart et al., 2009), and elevated rates of cigarette smoking contribute to dramatically reduced life expectancy among individuals with schizophrenia (Walker et al., 2015).”

“…also possible that the timing of these tweets in the late evening or early morning may reflect the negative effects that cigarette smoking is known to have on sleep quality (Phillips and Danner, 1995), as well as sleep disturbances that commonly occur among people with schizophrenia (Cohrs, 2008).”

“Exploratory studies have found that social media may be used for supporting mental health and well-being among people with schizophrenia (Naslund et al., 2014; Välimäki et al., 2016).”

“…was selected in this study because this platform has been previously used to explore smokingrelated communication among general population users (Myslín et al., 2013), and the Twitter platform has demonstrated promise for promoting smoking cessation efforts (Prochaska et al., 2012; Rocheleau et…”

“Persons with schizophrenia are often subjected to high levels of interpersonal stigma (Brohan et al., 2010; Lee et al., 2005), which can interfere with social functioning and can lead to increased risk of social isolation and withdrawal (Staring et al.”

“Persons with schizophrenia are often subjected to high levels of interpersonal stigma (Brohan et al., 2010; Lee et al., 2005), which can interfere with social functioning and can lead to increased risk of social isolation and withdrawal (Staring et al., 2009).”

“Despite high rates of tobacco use, studies have indicated that people with schizophrenia are interested in quitting smoking and express similar motivation to quit as smokers from the general population (Addington et al., 1998; Kinney et al., 1991).”

“The likelihood is low because about 1% of the population has a schizophrenia diagnosis (Millar et al., 2001).”

“A recent systematic review highlighted the acceptability and preliminary effectiveness of social media interventions for promoting smoking cessation in the general population (Naslund et al., 2017).”

“This is consistent with studies reporting very high prevalence of smoking among people with schizophrenia (Kelly et al., 2009).”

“…with schizophrenia are highly active on social media and use platforms like Facebook or Twitter at comparable rates as the general population (Birnbaum et al., 2015; Naslund et al., 2016a), highlighting the potential to use social media to reach and offer treatments to people with…”

“…are highly active on social media and use platforms like Facebook or Twitter at comparable rates as the general population (Birnbaum et al., 2015; Naslund et al., 2016a), highlighting the potential to use social media to reach and offer treatments to people with schizophrenia (Torous and…”

“In one study, a Facebook intervention with content tailored to the needs of young adult smokers contributed to an increase in quit attempts over a 12-month period (Ramo et al., 2015).”

“, 2013), and the Twitter platform has demonstrated promise for promoting smoking cessation efforts (Prochaska et al., 2012; Rocheleau et al., 2015).”

“In the Tweet2Quit randomized controlled trial, use of targeted messaging and peer-to-peer discussions on Twitter contributed to greater abstinence (Pechmann et al., 2017).”

“…that cigarette smoking is necessary for managing mental health symptoms (Trainor and Leavey, 2017) or providing relief from anxiety and other symptoms (Esterberg and Compton, 2005), and smoking as a way to spend time with others and facilitate social inclusion (Trainor and Leavey, 2017).”

“For instance, these patterns of tweeting about smoking could reflect higher likelihood of nicotine cravings during the late evening or early morning among dependent smokers (Chandra et al., 2011; Dunbar et al., 2010).”

“A high ratio indicates that a user has many people who follow their account and tweets but that they follow few other users' tweets, and has been identified as an indicator of influence on Twitter (McIver et al., 2015).”

“Exploratory studies have found that social media may be used for supporting mental health and well-being among people with schizophrenia (Naslund et al., 2014; Välimäki et al., 2016).”

“For instance, these patterns of tweeting about smoking could reflect higher likelihood of nicotine cravings during the late evening or early morning among dependent smokers (Chandra et al., 2011; Dunbar et al., 2010).”

“…that cigarette smoking is necessary for managing mental health symptoms (Trainor and Leavey, 2017) or providing relief from anxiety and other symptoms (Esterberg and Compton, 2005), and smoking as a way to spend time with others and facilitate social inclusion (Trainor and Leavey, 2017).”

“…active on social media and use platforms like Facebook or Twitter at comparable rates as the general population (Birnbaum et al., 2015; Naslund et al., 2016a), highlighting the potential to use social media to reach and offer treatments to people with schizophrenia (Torous and Keshavan, 2016).”

“Despite high rates of tobacco use, studies have indicated that people with schizophrenia are interested in quitting smoking and express similar motivation to quit as smokers from the general population (Addington et al., 1998; Kinney et al., 1991).”

“Previous studies have used social media to explore insomnia (McIver et al., 2015), monitor infectious diseases like dengue (Nsoesie et al., 2016), and track foodborne illness outbreaks (Hawkins et al., 2016).”

“, 2013), and the Twitter platform has demonstrated promise for promoting smoking cessation efforts (Prochaska et al., 2012; Rocheleau et al., 2015).”

“, 2016), and track foodborne illness outbreaks (Hawkins et al., 2016).”

“of tweeting about tobacco than control users [75].”

“Social media data have driven important public health research, including monitoring disease outbreaks [2], predicting health risk behaviors [3], accessing hard-to-reach populations [4], health promotion [5], user health-communication patterns [6], and mutual medical data sharing between patients [7].”

“Recently, exploring digital data has emerged as a promising method for examining human behavior and identifying symptoms of various mental and behavioral conditions [25-27].”

“Prior studies have demonstrated that the Twitter platform can act as an effective digital surveillance tool for monitoring a range of public health concerns (Gruebner et al., 2017; Hswen et al., 2017; McIver et al., 2015; Nsoesie et al., 2016a; Nsoesie et al., 2016b).”

“…of social media use has generated insights about tobacco use, mental health symptoms and suicide among social media users with schizophrenia, 49–51 while careful monitoring of smartphone use over time can detect changes in mobility and social behaviour as risk factors for relapse among…”

“Twitter has also demonstrated utility for identifying depression [32], monitoring attitudes about substance use [33], characterizing online discussions about tobacco use among people with schizophrenia [34], and examining psychological traits associated with health outcomes [35].”

“…mostly in studies intended to target an audience narrowed down to those who tweeted during a certain event or regarding a certain topic, such as smoking (Hswen et al. 2017), health conditions (Zhang and Ahmed 2019), ISIS support (Torregrosa et al. 2020), and natural disasters (Bica et al. 2021).”

“Widespread reach and penetration of online big data from social media has made it made it possible to capture real-time insights from a large number of individuals [12, 13, 14, 15, 16].”

“The Twitter platform has been widely recognized as a source to monitor public sentiment across a spectrum of health-related issues, including mental health [26-28], vaccination [29], and smoking [30].”

“A total of 𝑛 = 14 articles explore this expressive practice [11, 14, 21, 30, 33, 68, 69, 71, 94, 102, 111, 122, 140, 146], with 𝑛 = 11 focusing solely on digital text modalities applied across social media platforms (e.g., [68, 71, 122, 146]), chatbots [11, 33], text messaging systems [21], and…”