Study highlights potentially dangerous e-cigarette modifications by youth, adults

A new study led by Georgia State University researchers has found that more than 84% of youth and young adults who use e-cigarettes have modified their device, often in potentially dangerous ways.

A team of researchers led by Lucy Popova, an associate professor in the School of Public Health, conducted a national survey of nearly 2,000 youth and adult users of electronic nicotine delivery systems, commonly known as e-cigarettes or vapes. Their findings, published this month in the journal Scientific Reports, provide the first national-level data on the prevalence of vape modifications among different user groups.

“Many users don’t realize the potential dangers of modifying e-cigarettes,” Popova said. “When people adjust the voltage of a device or add substances to the liquid, they can increase their exposure to harmful chemicals like heavy metals.”

She noted that some of the modifications the study identified were benign and even intended—like replacing a battery or heating coil with an authorized part—but that 68% and 61% of youth and young adults, respectively, made modifications to the e-liquid such as making their own flavorings, adding additional nicotine or adding cannabis.

The researchers noted that making unauthorized battery modifications, which 40% of youth users reported doing, can also be dangerous. Wiring a new battery or using an unauthorized replacement battery could lead to overheating, a fire or an explosion. A study by another team of researchers identified more than 2,000 e-cigarette explosion and burn injuries from 2015 to 2017 that resulted in a visit to an emergency department.

E-cigarettes are the most commonly used tobacco product among youth, and the percentage of adults who vape has increased in recent years. Popova said that in addition to warning about the health risks associated with vaping, public health campaigns should warn about the potential risks of modifying e-cigarettes. Other tactics could include a focus on product labeling and instructions for safe use.

“Educating people is key,” Popova said, “because most people don’t know that modifying e-cigarettes could be dangerous.”