Infodemiology of alcohol use in Hong Kong mentioned on blogs: infoveillance study

Background: In 2007 and 2008, the beer and wine tax in Hong Kong was halved and then abolished, resulting in an increase of alcohol consumption. The prevalence of the Internet and a high blogging rate by adolescents and adults present a unique opportunity to study drinking patterns by infodemiology.

Objective: To assess and explain the online use of alcohol-related Chinese keywords and to validate blog searching as an infoveillance method for surveying changes in drinking patterns (eg, alcohol type) in Hong Kong people (represented by bloggers on a Hong Kong-based Chinese blogging site) in 2005-2010.

Methods: Blog searching was done using a blog search engine, Google Blog Search, in the archives of a Hong Kong-based blog service provider, MySinaBlog from 2005-2010. Three groups of Chinese keywords, each representing a specific alcohol-related concept, were used: (1) "alcohol" (ie, the control concept), (2) "beer or wine", and (3) "spirit". The resulting blog posts were analyzed quantitatively using infodemiological metrics and correlation coefficients, and qualitatively by manual effort. The infodemiological metrics were (1) apparent prevalence, (2) actual prevalence, (3) prevalence rate, and (4) prevalence ratio. Pearson and Spearman correlations were calculated for prevalence rates and ratios with respect to per capita alcohol consumption. Manual analysis focused on (1) blog author characteristics (ie, authorship, sex, and age), and (2) blog content (ie, frequency of keywords, description of a discrete episode of alcohol drinking, drinking amount, and genres).

Results: The online use of alcohol-related concepts increased noticeably for "alcohol" in 2008 and "spirit" in 2008-2009 but declined for "beer or wine" over the years. Correlation between infodemiological and epidemiological data was only significant for the "alcohol" prevalence rate. Most blogs were managed by single authors. Their sex distribution was even, and the majority were aged 18 and above. Not all Chinese keywords were found. Many of the blog posts did not describe a discrete episode of alcohol drinking and were classified as personal diary, opinion, or emotional outlets. The rest lacked information on drinking amount, which hindered assessment of binge drinking.

Conclusions: The prevalence of alcohol-related Chinese keywords online was attributed to many different factors, including spam, and hence not a specific reflection of local drinking patterns. Correlation between infodemiological data (represented by prevalence rates and ratios of alcohol-related concepts) and epidemiological data (represented by per capita alcohol consumption) was poor. Many blog posts were affective rather than informative in nature. Semantic analysis of blog content was recommended given enough expertise and resources.