April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Communicative Practices of DIY eJuice Mixing among International ENDS Users
According to the World Health Organization, the use of electronic nicotine delivery systems (ENDS) is increasing around the world with an estimated 35 million global users. More concerning is that contemporary trends in use are outpacing scientific understanding of the health implications. One such trend is do-it-yourself (DIY) eJuice mixing, which involves the unregulated homemade mixing of fogging agents, nicotine salts, and flavorants to create personalized liquid for ENDS products. Although these chemical ingredients can be readily purchased online or in-person from vaping retail stores, nicotine is listed by the US Department of Health and Human Services as hazardous and the other ingredients are not recommended for use by non-professionals. As regulatory uncertainty continues to plague public health messaging related to ENDS use, communities of DIY eJuice mixers are becoming increasingly common. Promoted as a cheaper way to mix eJuice with more control over the ingredients, trends in DIY eJuice mixing appear to be growing. Further, the novelty and wide array of flavors may be playing a role in initiation. At the same time, little to no regulations nor scientific examinations exist on DIY eJuice. To better understand this potentially high-risk group of ENDS users, the purpose of this study was to employ a grounded theory approach to explore the communicative practices of DIY eJuice mixing. This approach allowed for an inductive and iterative examination of the underlying behavioral processes surrounding an ENDS user’s decision to mix DIY eJuice. Participants were recruited locally for focus group discussions via SONA (n=4) and internationally for an open-ended survey via Prolific (n=138). Questions explored experiences with the online DIY eJuice community, motivations for mixing, information seeking strategies, flavor preferences, and perceived benefits of mixing. Unexpectedly, thematic analysis and flow sketching revealed the underlying processes of social cognitive theory (SCT) to explain the underlying determinants of DIY eJuice mixing behaviors. Results were further examined through a SCT lens, finding environmental determinants to emerge in the form of online and social influences; personal determinants in the form of curiosity and control; and behavioral determinants following a benefits/barriers analysis, particularly regarding cost. Environmental determinants outlined the role that socialization played in the decision to mix/consume DIY eJuice and suggest that future research should consider how health campaigns can utilize subjective and descriptive norms to counteract perceptions of social influences. Personal determinants revealed the strong role that curiosity and control play in deciding to mix DIY eJuice, suggesting that increased regulation of ENDS devices, without careful messaging, may result in boomerang effects that increase curiosity and stocking piling behaviors among the target population. Finally, behavioral determinants suggested that regulation of ENDS devices will be ineffective unless equal regulation is placed on DIY eJuice practices, or conceptions about the perceived financial cost to utilize more regulated ENDS are resolved through public health campaigns. These findings provide theoretical implications for the role of health communication constructs in understanding contemporary trends in ENDS use and practical implications for tobacco prevention advocacy and tobacco control regulations.