Users’ Modifications to Electronic Nicotine Delivery Systems (ENDS): Interviews with ENDS Enthusiasts

Abstract

Users’ modifications to electronic nicotine delivery systems (ENDS) products could increase initiation, inhibit cessation, or change the toxicity of the product. This study aims to begin to identify consumers’ common ENDS modification behaviors. We conducted audio-recorded, in-depth one-on-one interviews with 13 adult ENDS users in the metropolitan Atlanta area, who self-reported extensive modification experience. Modifications to coils, batteries, and e-liquids were commonly mentioned. Participants indicated that users modified devices to produce large clouds, change levels of nicotine delivery, alter tastes of e-liquids, and experience different throat hits. Because manufacturers have changed product characteristics to be in line with consumer preferences, interviewees indicated that fewer users currently engage in modifications to coils and batteries compared to the more widespread practice a few years ago. Hobbyists continue to perform modifications and many users continue to misuse or abuse e-liquids, despite the view that fewer users currently alter their ENDS than in the past. The Food and Drug Administration (FDA) regulatory actions that limit certain product characteristics may unintentionally increase the likelihood that users will once again make more extensive modifications to their products, and this should be considered as part of the FDA’s regulatory decision-making process.

Modifications to Electronic Nicotine Delivery Systems: Content Analysis of YouTube Videos

“…Yet, none of the videos in our sample showed how to adapt a nondripping device into a dripper. This finding resonates with recent interviews of ENDS enthusiasts, indicating that dripping modifications may be less frequent due to increased availability of commercially produced drippers and other devices that were previously only available via users’ modifications [ 14 ]. However, it should be noted that drippers were the most featured devices in YouTube videos.…”

“…YouTube is the most popular video-sharing site in the world [ 9 ], and YouTube has been identified as a major platform where ENDS users obtain and share information about ENDS products and modifications [ 12 - 14 ]. Many YouTube users are young, with 81% of those aged 15 to 25 years in the United States using YouTube [ 22 ].…”

“…An account was created on an incognito (private) browser to ensure browsing history did not influence the results. Search terms were derived from interviews with ENDS users [ 14 ] and the current literature [ 10 ] indicating that “vape” and “vaping” are common and inclusive terms used by ENDS enthusiasts to describe a number of different ENDS devices. Search phrases included the following: “vape DIY (ie, do it yourself),” “vape build DIY,” “vape custom build,” “vape modification,” “vape rebuild DIY,” “vape coil rebuild,” “vape coil DIY,” “vape ohm rebuild,” “vape ohm DIY,” “vape e-juice DIY,” “vape e-juice custom build,” “vape voltage DIY,” “vape voltage custom build,” “vape RBA (ie, rebuildable atomizer) custom build,” “vape RBA DIY,” “vape dripping custom build,” “vape dripping DIY,” “vape refill custom build,” “vape refill DIY,” “vaping custom build,” “vaping DIY,” “vaping modif* custom build,” “vaping rebuild DIY,” “mods rebuild DIY,” “vape chang* DIY,” “vape chang* custom build,” “vape wattage DIY,” and “vape wattage custom build.” Search terms were entered into the YouTube search engine, and the top 10 results for each phrase were included (N=280).…”

“…We developed a codebook based on interviews with ENDS users [ 14 ], previous literature [ 10 , 15 ], and expert consensus. By expert consensus, we refer to review by our interdisciplinary team of collaborators with substantial expertise in ENDS use behavior and ENDS product research.…”

“…YouTube is the most popular video-sharing site in the world [ 9 ], and there are a large number of ENDS videos on YouTube [ 10 ], including videos about ENDS modifications [ 11 ]. YouTube has been identified as a major platform where ENDS users obtain and share information about ENDS products and modifications [ 12 - 14 ]. However, a comprehensive study of ENDS modification videos on YouTube is lacking.…”