Anti-Asian racism has intensified during the COVID-19 pandemic and recent political events, fueling media hate and adversely affecting Asian communities. We investigate how anti-Asian racism exposure via media influences Asian activism across five dimensions-collective, financial, dialogic, online, and symbolic. Analysis of survey responses from nearly 800 Asians across the United States indicates that media racism exposure was positively associated with Asian activism and indirectly linked to engagement through higher racial self-esteem and greater perceived severity of anti-Asian racism.

The US FDA has authorized several modified risk tobacco products (MRTPs), permitting marketing claims around modified exposure (i.e. lower exposure to harmful substances compared to cigarettes). We propose that this FDA authorization may serve as a heuristic cue, influencing how people visually attend to the U.S. Surgeon General's warning to discourage tobacco use and perceive MRTPs and their marketing messages among young tobacco users and non-users. We conducted a 3 (claims: FDA-authorized modified exposure claim vs. the claim only vs. no claim) ×2 (tobacco use status: users vs. non-users) between-subjects factorial experiment with 88 young adults. Eye-tracking and survey data were collected during and after showing a one-minute commercial video for an MRTP, which included the claim and the warning. Participants exposed to FDA-authorized modified exposure claims spent significantly less time looking at the warning and reported greater intent to try the product than the other conditions. While visual attention to the warning did not differ significantly between tobacco users and non-users, tobacco users reported higher interest and intent to try the product. Additionally, there was a significant interaction effect between the claim condition and tobacco use; tobacco users rated the risk of a MRTP significantly lower than non-users only when exposed to the FDA-authorized claim. Our findings support scholarly concerns about the negative impact of FDA-authorized marketing claims for newer tobacco products on young people. Modified exposure claims endorsed by the FDA can reduce attention to risk information, making young people more receptive to tobacco marketing.

Background:Tobacco harm reduction (THR) has become increasingly prominent in global tobacco discourse, with industry actors and advocates actively shaping messaging on social media platforms. Objective:This study aimed to analyze how THR is discussed on X (formerly known as Twitter), examining message valence toward THR (pro, anti, mixed, or none), stakeholder participation, geographic and temporal variation, and the involvement of industry and THR advocates. Methods:We conducted a content analysis of 17,361 posts related to THR from 87 countries, published between July 2019 and December 2023. Thematic analysis was used to identify dominant narratives. Results:Pro-THR posts comprised the majority (12,393/17,361, 71.4%), followed by anti-THR (3925/17,361, 22.6%) and neutral or mixed messages (63/17,361, 0.4%). Pro-THR messages were most prevalent in high-income countries (9193, 78.3%) and were primarily disseminated by THR advocates (7084/7426, 95.4%), tobacco users (3618/3692, 98%), and industry-affiliated accounts (973/1042, 93.3%). Anti-THR posts were more common among government entities (276/333, 82.9%), tobacco control advocates (256/364, 70.3%), and in lower-middle-income regions (149/244, 61.2%). Self-identified health care providers represented 9.4% (1629/17,361) of the dataset, with their posts nearly evenly split between pro-THR (716/1629, 44%) and anti-THR (826/1629, 50.7%) narratives. Pro-THR narratives emphasized the safety and smoking cessation potential of newer nicotine and tobacco products, consumer rights, and skepticism toward public health authorities. In contrast, anti-THR messages focused on youth protection, health risks of newer products, distrust of industry motives, and advocated for complete cessation of tobacco and nicotine use. Notably, 39.6% (6881/17,361) of THR-related posts mentioned newer products, and 15.7% (2724/17,361) included marketing efforts. There was a marked increase over time in overall THR-related post volume, posts by THR advocates, product mentions, and marketing attempts. Overall, high-income countries contributed the majority of posts (11,739/17,361, 67.6%) while nearly half originated from North America (8553/17,361, 49.3%). Conclusions:The online discourse surrounding THR is characterized by a predominance of pro-THR messaging, particularly in high-income countries and among industry-affiliated stakeholders. The growing volume of THR advocacy and marketing efforts on social media presents new challenges for tobacco regulation and public health policy.

OBJECTIVE:Philip Morris International's Smoke-Free Future (SFF) campaign pledged to replace conventional cigarettes with smoke-free alternatives, promoting smokers' health and combating smoking-related misinformation. METHOD:We interviewed 25 college students to assess their perceived credibility of SFF messages and interest in smoke-free products. RESULTS:Nearly half couldn't identify a tobacco company as the message source, speculating it came from public health entities. Many overlooked profit motives, instead seeing SFF as genuinely supportive of smoking cessation and being aligned with public health. About a third found the message credible, citing factors like lay narrators and language/images signifying science. Most expressed interest in smoke-free products, driven by curiosity and misunderstanding of their health implications. CONCLUSION:Our study underscores concern that recent tobacco corporate communications may influence young people's interest in these products, even without explicit promotion, necessitating better education about industry tactics to disguise their identity with health and science initiatives, while undermining tobacco control efforts.

Objectives: Anti-Asian American racism has negatively impacted Asian Americans' mental health. This study investigated how colorblind racial ideology moderates the relationship between COVID-19 racial discrimination and depressive symptoms among Asian Americans. Design: Data come from an online survey conducted among 794 Asian Americans. Multivariable logistic regression analyses were conducted to test the effects of racial discrimination and colorblind racial attitude on depressive symptoms among Asian Americans, stratified by nativity (451 US-born, 343 foreign-born). Results: We found that US-born Asian Americans than foreign-born Asian Americans had higher odds of depressive symptoms, whereas the foreign-born displayed higher levels of colorblind racial attitude. The results of multivariable logistic regression tests indicate that colorblind racial attitude moderates the relationship between racial discrimination and depressive symptoms among the US-born, but not among the foreign-born. Conclusion: Instead of claiming that race no longer matters, more racially conscious socialization and education that promote the awareness of race and racism are warranted to promote mental health of Asian Americans.

The global COVID-19 pandemic reinforced anti-Asian biases, accompanied by the rise of violence against Asians. We examined Asian Americans’ engagement in activism to combat anti-Asian racism and advance their community using the situational theory of problem solving (STOPS) and two additional factors—past discrimination and subjective norms. Asian American activism includes social media, political, and advocacy actions. Structural equation modeling was conducted with data from online survey responses of 240 Asian Americans. Our results suggest pathways from Asian Americans’ past racism experiences to political and advocacy actions via three perceptual factors in STOPS (problem, involvement, constraint recognition), subjective norms, and expression of opinion on social media.

We investigate social media discourses on the relationship between cancer and COVID-19 vaccines focusing on the key textual topics, themes reflecting the voice of cancer community, authors who contribute to the discourse, and valence toward vaccines. We analyzed 6,427 tweets about cancer and COVID-19 vaccines, posted from when vaccines were approved in the U.S. (December 2020) to the February 2022. We mixed quantitative text mining, manual coding and statistical analysis, and inductive qualitative thematic analysis. Nearly 16% of the tweets posted by a cancer community member mentioned about refusal or delay of their vaccination at the state/local level during the initial rollout despite the CDC's recommendation to prioritize adults with high-risk medical conditions. Most tweets posted by cancer patients (pro = 82.4% vs. anti = 5.1%) and caregivers (pro = 89.2% vs. anti = 4.2%) showed positive valence toward vaccines and advocated for vaccine uptake increase among cancer patients and the general population. Vaccine hesitancy, self-reported adverse events, and COVID-19 disruption of cancer treatment also appeared as key themes. The cancer community called for actions to improve vaccination procedures to become safe and accessible especially for elderly cancer patients, develop COVID-19 vaccines suitable for varying type, stage, and treatment of cancer, and advance cancer vaccines. Future research should continue surveilling conversations around continuous impacts of COVID-19 interference with the cancer control continuum, beyond vaccination, focusing on the voice and concern of cancer community.

Anti-intellectualism (resentment, hostility, and mistrust of experts) has become a growing concern during the pandemic. Using topic modeling and supervised machine learning, this study examines the elements and sources of anti-Fauci tweets as a case of anti-intellectual discourse on social media. Based on the theoretical framework of science-related populism, we identified three anti-intellectual discursive elements in anti-Fauci tweets: people-scientist antagonism, delegitimizing the motivation of scientists, and delegitimizing the knowledge of scientists. Delegitimizing the motivation of scientists appeared the most in anti-Fauci tweets. Politicians, conservative news media, and non-institutional actors (e.g. individuals and grassroots advocacy organizations) co-constructed the production and circulation of anti-intellectual discourses on Twitter. Anti-intellectual discourses resurged even under Twitter's content moderation mechanism. We discuss theoretical and practical implications for building public trust in scientists, effective science communication, and content moderation policies on social media.

Early news coverage of COVID-19 influenced public suspicions of Asians as being the origin and carriers of the disease, and stigmatizing and racist terms (e.g., "Kung flu", "Chinese virus", "Wuhan virus") have been improperly used to refer to the virus. The racist rhetoric, accompanied by increasing verbal and physical attacks, has impacted the lives of Asian Americans during the pandemic. The present study investigates targeted Asian Americans' communication responding to the aggressors of COVID-19 racism in application of co-cultural communication theory. Targeted individuals' characteristics and previous experience of racial discrimination are tested as determinants of such communicative responses. Data come from 242 Asians across the U.S. who reported having experienced racism during the COVID-19 pandemic. Among the three identified types of communication responses, the nonassertive approach was used most intensively by Asian Americans in responding to COVID-19 racism, followed by the assertive and aggressive ones. Salient ethnic identity and previous discrimination experience were associated with a higher level of nonassertive and a lower level of aggressive approach. Males were more likely to practice assertive approaches. Our findings contribute to the extension of the co-cultural communication framework in explaining Asian Americans' communicative responses to pandemic-fueled racism.

Using data from a national survey in South Korea, this study offers micro-level evidence for the two-culture model of public understanding of science, which posits that a shift from an industrializing to a post-industrial society is accompanied by a transition from a culture of idealized science to a culture of skepticism. We investigate whether older South Koreans, who spent much of their lives during the intense industrialization of the country, hold more positive perceptions about science than younger generations, who grew up mostly in a post-industrial era. As predicted, older individuals perceived greater contributions of science, suggesting that they held more idealized perceptions of science than younger individuals. Perceived importance of economic development, scientific knowledge, ideology, uncertainty of scientific risks, and formal education mediated the link between age and perceived contributions of science, suggesting that these mediators may function as causal mechanisms that could explain why citizens in post-industrial societies tend to have more skeptical perceptions about science than those in industrializing countries.

ABSTRACT Using a survey of college students in the US, this study examines whether the way students attribute responsibility is associated with perceived risk of sexual assaults and willingness to engage in preventive behaviours. We then link news media use to attributions of responsibility to examine whether media use is related with risk perceptions and preventive behaviours through the mediation of attributions of responsibility. Attributing responsibility to victims was correlated with perceiving a lower risk, while finding colleges responsible was related with perceiving a greater risk. Such relationships were moderated by gender, suggesting that attributions of responsibility might have different effects between male and female students. Attributions of responsibility were also associated with helping victims and taking protective measures. Finally, news media use was positively correlated with blaming victims, while negatively associated with finding perpetrators responsible, and these attributions of responsibility mediated the link between media use and the outcome variables. PRACTICE IMPACT STATEMENT This article will assist educators and professionals in designing strategies for sexual assault prevention by explaining how attributing responsibility to victims, perpetrators, or colleges is related to college student's perceived risk and willingness to engage in preventive behaviours.

Jungmi Jun and Nanlan Zhang contend that stigmatizing and racist terms, such as “Kung flu,” “Chinese virus,” and “Wuhan virus,” have been used to refer to the COVID-19 virus since the first report of COVID-19 outbreak in Wuhan, China. The racist rhetoric has impacted the lives of Asian Americans during the pandemic. This chapter discusses the racist rhetoric of U.S. government officials, the biased COVID-19 news coverage, and their impact on public discourses. Jun and Zhang present the type and prevalence of COVID-19 racist attacks and discrimination experienced by Asian Americans across the nation identified from their recent survey and Asian advocacy groups’ incident reports in conjunction with the history of anti-Asian racism in U.S. society. The authors discuss the impact of COVID-19 racism on Asian Americans’ mental and physical health and report survey findings regarding Asian Americans’ anxiety and behaviors during the pandemic. In addition, Jun and Zhang introduce various activism movements to combat anti-Asian COVID-19 racism. The authors summarize scholars’ future directions to assist Asian Americans in coping with the detrimental impact of COVID-19 racism as well as promoting active engagement in racial justice movements.

Background: The U.S. Food and Drug Administration (FDA) authorized the marketing of the IQOS tobacco heating system as a modified risk tobacco product (MRTP) in July 2020, permitting its 'reduced exposure' marketing. This decision is accompanied by much controversy among the global health community. We provide a preliminary analysis of Twitter conversations regarding the MRTP authorization of IQOS by identifying the authors, valence towards the policy decision, source of cited link, and focused topic. Methods: We analyzed 548 tweets mentioning MRTP posted between July 2016 (when PMI submitted the proposal) and October 2020. Results: We found a higher proportion of pro-MRTP valence (25.4%) than anti-MRTP (16.2%). Nearly half of the tweets (47.2%) expressing personal opinions presented pro-MRTP valence (vs. anti-MRTP = 23.9%). The FDA website was more frequently cited in pro-MRTP tweets (30.8% vs. anti = 4.8%), while tobacco control advocates' websites were cited only in anti-MRTP tweets (77.4% vs. pro = 0). Pro-MRTP valence appeared more frequently in tweets mentioning health (53.1% vs. anti =38.5%) and cessation (100% vs. anti = 0). Nearly 42% of tweets showed a bot score greater than .43, indicating a possibility of automation. Conclusion: Continuous efforts are needed to surveil the industry's attempts to create a climate of false consensus and circulate misinformation regarding MRTP on social media, as well as to assist non-scientific audiences' understanding of MRTP.

As Twitter emerged as an important data source for pharmacovigilance, heterogeneous data veracity becomes a major concern for extracted adverse drug reactions (ADRs). Our objective is to categorize different levels of data veracity and explore linguistic features of tweets and Twitter variables as they may be used for automatic screening high-veracity tweets that contain ADR-related information. We annotated a published Twitter corpus with linguistic features from existing studies and clinical experts. Multinomial logistic regression models found that first-person pronouns, expressing negative sentiment, ADR and drug name being in the same sentence were significantly associated with higher levels of data veracity (p<0.05), using medical terminology and fewer indications were associated with good data veracity (p<0.05), less drug numbers were marginally associated with good data veracity (p=0.053). These findings suggest opportunities for developing machine learning models for automatic screening of ADR-related tweets using key linguistic features, Twitter variables, and association rules.

Background: Many countries show low COVID-19 vaccination rates despite high levels of readiness and delivery of vaccines. The public's misperceptions, hesitancy, and negative emotions toward vaccines are psychological factors discouraging vaccination. At the individual level, studies have revealed negative perceptual/behavioral outcomes of COVID-19 information exposure via social media where misinformation and vaccine fear flood. Objective: This study extends research context to the global level and investigates social media discourse on the COVID-19 vaccine and its association with vaccination rates of 192 countries in the world. Methods: COVID-19 vaccine tweets were compared by country in terms of (1) the number per million Twitter users, (2) mentions of adverse events-death, side-effects, blood clots, (3) negative sentiment (vs. positive), and (4) fear, sadness, or anger emotions (vs. joy). Artificial intelligence (AI) was adopted to classify sentiment and emotions. Such tweets and covariates (COVID-19 morbidity and mortality rates, GDP, population size and density, literacy rate, democracy index, institutional quality, human development index) were tested as predictors of vaccination rates in countries. Results: Over 21.3 million COVID-19 vaccine tweets posted between November 2020 and August 2021 worldwide were included in our analysis. The global average of COVID-19 vaccine tweets mentioning adverse events was 2% for 'death', 1.15% for 'side-effects', and 0.80% for 'blood clots'. Negative sentiment appeared 1.90 times more frequently than positive sentiment. Fear, anger, or sadness appeared 0.70 times less frequently than joy. The mention of 'side-effects' and fear/sadness/anger emotions appeared as significant predictors of vaccination rates, along with the human development index. Conclusions: Our findings indicate that global efforts to combat misinformation, address negative emotions, and promote positive languages surrounding COVID-19 vaccination on social media may help increase global vaccination uptakes.

Objectives: Emerging evidence indicates that young adults who use e-cigarettes can withhold greater exposure to COVID-19 risk. We examine how young e-cigarette users perceive COVID-19 related threat of e-cigarette use and benefit of cessation as compared to traditional ones, applying the health belief model. We investigate changes of such perceptions during the pandemic and their associations with past attempt and future intent to quit e-cigarette use. Methods: We collected responses from US young adults (aged 18-25) who have used e-cigarettes in the past month by conducting 2 waves of online surveys in 2020 (wave 1, N=165) and 2021 (wave 2, N=347). Results: Young e-cigarette users in wave 2 reported greater estimates of COVID-19 and traditional threat as well as COVID-19 and traditional benefit of quitting than wave 1. However, we also found significant increases of e-cig dependence, perceived barriers of quitting, and the percentage of young e-cigarette users (33%) who had never attempted to quit in the past month. Importantly, a COVID-19 benefit of cessation and efficacy of quitting were significantly associated with cessation intent. Conclusions: Ongoing efforts are required to track post-pandemic e-cigarette risk perceptions and behaviors, as well as to identify strategies to mitigate increased dependence and usage of e-cigarettes.

Background We analyse news representations of the regulation of heated tobacco products (HTPs) in South Korea, the country where HTP use is among the highest in the world despite conflicts between the government and the HTP manufacturers. Methods We analysed a total of 571 print and TV news covering HTP regulations, published between 2017 and 2018, the time period when HTPs were introduced to the country and various regulations of HTPs were proposed and implemented. We assessed the prevalence and associations among specific types of HTP regulations that were discussed, valence towards regulation, sources, framing of the relative health risks/benefits of HTPs compared with conventional cigarettes. Results Taxation (55.2%) and warning labels (25.7%) were two regulation topics covered the most. Almost equal proportions of pro-regulation (2.5%) and anti-regulation valence (2.2%) were found in taxation-related news, while pro-regulation valence appeared more frequently for other restrictions, including warning labels (pro=9.5% vs anti=1.4%), marketing restrictions (pro=6.9% vs anti=0%) and integration of HTPs into smoke-free policies for cigarettes (pro=8.7% vs anti=0%). The government (59%), followed by the tobacco industry (39.4%), was the source cited most often across news stories while the presence of tobacco control advocates was low (4.9%). As for framing, there was no significant difference in the prevalence of stories mentioning reduced harm (31.7%) and equal or more harm (33.6%) of HTPs compared with cigarettes. Conclusions We provide implications for governments and tobacco control advocates on building consensus for applying cigarette equivalent taxes and pictorial warning labels to HTPs.