• Patricia Cavazos-Rehg, Melissa Krauss, Richard Grucza, and Laura Bierut.
• Washington University School of Medicine, St. Louis, MO, United States. rehgp@psychiatry.wustl.edu.
• J. Med. Internet Res. 2014 Jan 1;16(6):e157.

BackgroundTwitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages.ObjectivesThe intent of the study was to assess the content of "tweets" and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho).MethodsWe assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic.ResultsA total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were African American (323,107/759,407; 42.55%) or Hispanic (90,732/759,407; 11.95%) than the Twitter median average (African American 22.4%, inter-quartile ratio [IQR] 5.1-62.5%; Hispanic 5.4%, IQR 3.0-10.8%) and among Hispanics, @stillblazingtho was in the top 30% of all Twitter handles followed.ConclusionsYoung people are especially responsive to social media influences and often establish substance use patterns during this phase of development. Our findings underscore the need for surveillance efforts to monitor the pro-marijuana content reaching young people on Twitter.

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