Public Reactions to the New York State Policy on Flavored Electronic Cigarettes on Twitter: Observational Study

BackgroundFlavored electronic cigarettes (e-cigarettes) have become popular in recent years, especially among youth and young adults. To address the epidemic of e-cigarettes, New York State approved a ban on sales of most flavored vaping products other than tobacco and menthol flavors on September 17, 2019.ObjectiveThis study aims to examine the attitude of Twitter users to the policy on flavored e-cigarettes in New York State and the impact of this policy on public perceptions of e-cigarettes. This study also compares the attitudes and topics between New York Twitter users and Twitter users from other states who were not directly affected by this policy.MethodsTweets related to e-cigarettes and the New York State policy on flavored e-cigarettes were collected using the Twitter streaming application programming interface from June 2019 to December 2019. Tweets from New York State and those from other states that did not have a flavored e-cigarette policy were extracted. Sentiment analysis was applied to analyze the proportion of negative and positive tweets about e-cigarettes or the flavor policy. Topic modeling was applied to e-cigarette–related data sets and New York flavor policy–related data sets to identify the most frequent topics before and after the announcement of the New York State policy.ResultsWe found that the average number of tweets related to e-cigarettes and the New York State policy on flavored e-cigarettes increased in both New York State and other states after the flavor policy announcement. Sentiment analysis revealed that after the announcement of the New York State flavor policy, in both New York State and other states, the proportion of negative tweets on e-cigarettes increased from 34.07% (4531/13,299) to 44.58% (18,451/41,390) and from 32.48% (14,320/44,090) to 44.40% (64,262/144,734), respectively, while positive tweets decreased significantly from 39.03% (5191/13,299) to 32.86% (13,601/41,390) and from 42.78% (18,863/44,090) to 33.93% (49,105/144,734), respectively. The majority of tweets related to the New York State flavor policy were negative both before and after the announcement of this policy in both New York (87/98, 89% and 3810/4565, 83.46%, respectively) and other states (200/255, 78.4% and 12,695/15,569, 81.54%, respectively), while New York State had a higher proportion of negative tweets than other states. Topic modeling results demonstrated that teenage vaping and health problems were the most discussed topics associated with e-cigarettes.ConclusionsPublic attitudes toward e-cigarettes became more negative on Twitter after New York State announced the policy on flavored e-cigarettes. Twitter users in other states that did not have such a policy on flavored e-cigarettes paid close attention to the New York State flavor policy. This study provides some valuable information about the potential impact of the flavored e-cigarettes policy in New York State on public attitudes toward flavored e-cigarettes.     

A Coalition to Influence Public Policy

No abstract available for this article.     

Legal and Policy Barriers to Sharing Data Between Public Health Programs in New York City: A Case Study

Integration of public health surveillance data within health departments is important for public health activities and cost-efficient coordination of care. Access to and use of surveillance data are governed by public health law and by agency confidentiality and security policies.In New York City, we examined public health laws and agency policies for data sharing across HIV, sexually transmitted disease, tuberculosis, and viral hepatitis surveillance programs. We found that recent changes to state laws provide greater opportunities for data sharing but that agency policies must be updated because they limit increased data integration.Our case study can help other health departments conduct similar reviews of laws and policies to increase data sharing and integration of surveillance data.State and local laws mandate the reporting of specific infectious diseases to health departments, which, in turn, use these surveillance data to monitor trends, obtain funding, and allocate resources for controlling infectious diseases. Sharing infectious disease surveillance data within a health department is vital to understanding how one disease may place a person at risk for another disease (e.g., HIV and tuberculosis), how characteristics or behaviors may predispose a person to multiple infectious diseases (e.g., enteric infections and sexually transmitted diseases among men who have sex with men), and how diseases may be clustered in specific geographic areas. Understanding these relationships helps health departments and community provider partners integrate education, screening, and treatment programs to save costs and improve population health. In addition, sharing data is critical for routine case investigations and for investigating outbreaks, which are core functions of health departments.1 The public health need for health department programs to increase data sharing to develop more integrated and cost-efficient systems of care is also in keeping with the goals of the Affordable Care Act.2Local jurisdictional efforts to integrate surveillance data support the national-level goals of the Centers for Disease Control and Prevention (CDC).3 In 2010, the New York City Department of Health and Mental Hygiene (DOHMH) began implementing CDC’s Program Collaboration and Service Integration initiative.4 This initiative aims to strengthen collaboration within health departments across HIV/AIDS, sexually transmitted disease (STD), tuberculosis (TB), and viral hepatitis programs by decreasing duplication of efforts; improving data sharing to better understand and address co-occurrence, coinfection, and syndemics of disease; and facilitating delivery of integrated services to the public. Vital to this initiative are local and state health departments’ commitment and continued efforts to improve data sharing.5 Recent CDC guidelines are aimed at increasing data sharing by strengthening and standardizing data security and confidentiality procedures for state and local HIV, viral hepatitis, STD, and TB surveillance programs.6Despite the strong public health rationale for sharing data, several factors affect the ability of health departments to integrate infectious disease data, such as historically siloed funding coupled with the need for technological improvements and resources to implement, update, and maintain an integrated surveillance registry system. Moreover, the state and local laws that authorize the collection of data may actually impede the ability of health departments to share, analyze, and make use of data across separate disease programs.As part of New York City’s implementation of the Program Collaboration and Service Integration initiative, we carried out a case study to identify factors that affect data sharing, specifically examining the role of public health laws and agency policies on internal sharing of HIV, STD, TB, and viral hepatitis surveillance data.7 Our case study focused on HIV, STDs, TB, and viral hepatitis; however, the lessons learned can be applied to other reportable diseases and conditions. This case study can help other state and local health departments to conduct similar reviews of laws and policies to work toward increased data sharing and integration of surveillance data.     

Leveraging Public Health Research to Inform State Legislative Policy that Promotes Health for Children and Families

Maternal and Child Health Journal - Purpose Engagement in policy is an essential public health service, with state legislatures serving as important arenas for activity on issues affecting children...     

Public Financing of IVF: A Review of Policy Rationales

There is great diversity in in vitro fertilization (IVF) funding and reimbursement policies and practice throughout Europe and the rest of the world. While many existing reimbursement and regulatory frameworks address safety and legal concerns, economic factors also assume a central role. However, there are several problems with the evidence that is available on the economics of IVF. This suggests there is a need for more robust cost-effectiveness studies. It also indicates the need for alternative rationales to justify the reimbursement of IVF, which might more fully account for the social, political, ethical, and philosophical considerations embedded in notions of infertility and technology-driven reproductive treatments. The merits and limitations of five alternative rationales are discussed. The review suggests that while no existing single rationale provides a complete framework with which to support funding decisions, taken together they provide guideposts which signal important issues for consideration and highlight where further research, action, and debate are needed.