Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 21, 2019
Date Accepted: Feb 26, 2020
Date Submitted to PubMed: Apr 30, 2020
Modifications to Electronic Nicotine Delivery Systems (ENDS): A Content Analysis of YouTube Videos
ABSTRACT
Background:
Because user modification can alter the addictiveness and toxicity of electronic nicotine delivery systems (ENDS), more research is needed to understand the types, motivations, risks and information sources (such as YouTube) that lead to these product alterations.
Objective:
To analyze the content of YouTube videos depicting modifications of ENDS.
Methods:
Content analysis of 168 YouTube videos conducted in 2019.
Results:
Videos were 1-108 minutes long (median = 9.55). Presenters were largely male (70%, 117/168), White (56%, 94/168), and older than 25 (56%, 94/168). Most videos gave “how to” instructions (88%, 148/168), but few offered warnings (18%, 30/168) or mentioned commercial alternatives to modifications they presented (10%, 16/168). The ENDS devices most often featured were drippers (38%, 63/168) and refillable tanks (22%, 37/168). The most often modified ENDS components were coils (45%, 76/168) and e-liquids (13%, 22/168). Most videos portrayed ENDS modifications positively (63% positive [106/168], 36% neutral [60/168], 1% negative [1/168]) and were either neutral or positive in their portrayal of ENDS devices overall (46% positive [78/168], 53% neutral [53/168], 1% negative [1/168]).
Conclusions:
This study identified several concerning trends in popular YouTube videos on ENDS modifications, including lack of warnings, adding marijuana derivatives to e-liquids, and the positive portrayal of ENDS devices and modifications. By identifying types of modifications (coil and e-liquid being the most prevalent), this study sets an agenda for research on the effects of modifications.
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