Parsing Instagram Posts for Smoking Imagery Amongst Users: A Content Analysis.

BACKGROUND: Despite legal restrictions on tobacco advertising, social media platforms have emerged as largely unregulated spaces for indirect tobacco promotion. Image-based networks such as Instagram intensify this threat through visibility, influencer marketing, and normalization of smoking among youth. This study analysed the prevalence and nature of smoking imagery on Instagram to assess patterns of sentiment, product portrayal, and policy violations. METHODS: A content analysis of 750 Instagram posts containing fifteen smoking-related hashtags was conducted between February and May 2023. An eight-domain codebook classified posts by sentiment, artifact visibility, tobacco use, smoke play, health warning, anti-smoking awareness, brand promotion, and artifact type. Descriptive statistics were generated using SPSS v25, and WordCloud analysis identified recurring themes. RESULTS: Posts demonstrated high visibility and engagement (mean likes: 361.8±607.5; comments: 12.7±18.8; user followers: 17,262±48,138). Positive sentiment dominated (79.7%), while negative sentiment was rare (0.9%). Smoking artifacts were visible in 75.6% of posts, with explicit tobacco use in 61.9%. Smoke play appeared in 20.3%. Brand promotion was present in 22.3% of posts. Health warnings (2.8%) and anti-smoking intent (1.5%) were less common. Cigarettes were most common (61.2%), followed by ENDS (17.9%), marijuana (8.2%), and hookah (6.8%). WordCloud analysis revealed four themes: gendered smoking identity, fetishization, cultural pairing, and increasing vaping imagery. CONCLUSION: Smoking is widely normalized and aesthetically portrayed on Instagram, with substantial engagement and covert brand presence despite regulatory bans. Limited health messaging and strong visual messaging highlight gaps in digital tobacco control, emphasising the need for strengthened tobacco control regulations and active social media surveillance.