Introduction:
The sale of e-cigarettes containing nicotine is prohibited in all Australian states and territories, yet the increased availability and convenience of the internet enables promotion and exposure across countries. A central feature of many universal social media platforms is the sharing of images. As a result of the increased pervasiveness of social media, the role of marketing and peer influence in the uptake of smoking has become particularly salient as social media can be a powerful tool used to influence risk behaviours.

Objectives:
To investigate how e-cigarettes are portrayed and promoted on Twitter using a content analysis approach of posts containing an image.

Methods:
1,303 tweets and accompanying images from 2012, 2014, 2016 and 2018 were analysed, collected through TrISMA (Tracking Infrastructure for Social Media Analysis), a contemporary technical and organisational infrastructure for the tracking of public communication by Australian users of social media, via a list of 15 popular e-cigarette related terms.

Results:
Despite Australia’s cautious approach toward e-cigarettes and the limited evidence supporting them as an efficacious smoking cessation aid, there is a concerted effort from some Twitter users to promote these devices as a health conducive (7%) smoking cessation product (20%). Twitter is being used in an attempt to circumvent Australian regulation and advocate for a more liberal approach towards personal vaporisers (7%). Twenty-seven percent of posts were dedicated to selling or promoting vape products, and 20% were business listings that used methods to expand their clientele by touting competitions and giveaways.

Conclusion(s):
The borderless nature of social media presents a clear challenge for the enforcement of Article 13 of the World Health Organization Framework Convention on Tobacco Control, which requires all ratifying nations to implement a ban on tobacco, advertising, promotion and sponsorship. Countering advertising and promotion of these products will require cross-border cooperation with other WHO FCTC parties.

Funding Acknowledgments:
This work was supported by a Healthway Exploratory Research Grant (grant number 32803) and an Australian Government Research Training Program Scholarship. The Scholarship is provided by the Commonwealth of Australia to support general living costs for students (KM) undertaking Research Doctorate studies. This research was also supported by the Faculty of Health Sciences, Curtin University 2019 Health Sciences Summer Scholarship Initiative. The Scholarship is provided by the Faculty of Health Science, Curtin University to support the general living costs of undergraduate students (KT) to undertake a research project. All funders had no role in the design of the study; in the collection, analyses, or interpretation of data; and in the decision to present the results. This research was also supported by infrastructure provided through the Australian Research Council-funded project TrISMA: Tracking Infrastructure for Social Media Analysis (LIEF grant LE140100148).