BACKGROUND-AIM:
Social media platforms are major channels for tobacco marketing targeting adolescent and young adult women. Such platforms can be a powerful tool for surveillance of targeted promotion strategies and social norms related to tobacco and nicotine use among this population. This study assessed how nicotine and tobacco products are discussed and promoted in the context of weight management on X/Twitter.

METHODS:
Keyword queries were used to collect posts co-referencing tobacco use and weight control/fitness/body image from X/Twitter from 09/01/2021 to 10/31/2023 using TalkWalker—an official X/Twitter data provider. Key measures included tweet volume, user profile descriptions, hashtags, and engagement metrics. Posts were coded for thematic content including promotional strategies using a combination of machine learning methods, keyword algorithms, and human coding.

RESULTS:
Keyword filters captured 45275 relevant tweets. Among users reporting age in their X/Twitter bio, 39.8% were under the age of 18 and 56.3% were age 18 to 26. Popular hashtags were #weightloss, #edtwt, #vape, #smoke, and #fitness. Highly engaged tweets featured themes related to self-monitoring through body “checks”/selfies while smoking, mental health conditions (especially eating disorders) and nicotine as a coping strategy, glamorization of nicotine use through celebrity references, sex/gender stereotypes, unhealthy dieting practices, promotion of novel nicotine products including new user appeals (e.g., appetite suppressant claims), as well as promotion of products (e.g., diet, fashion, technology) on e-commerce websites.

CONCLUSIONS:
Tobacco control initiatives should not only counter the glamorization of tobacco use among youth and young adults but also address the normalization of nicotine as a weight-control tool and its portrayal as a coping mechanism for mental health challenges. Public health messaging must target vulnerable populations, including youth and individuals with eating disorders, while dispelling misconceptions about nicotine’s role in weight management and wellness. Additionally, regulatory efforts should monitor and restrict promotional content on social media platforms, particularly influencer-driven campaigns that embed nicotine marketing within weight-loss and lifestyle narratives. Collaboration with social media companies to enhance content moderation and provide mental health resources is critical to mitigating the risks posed by these harmful online discourses.