Notes from the Field: Environmental Contamination from E-cigarette, Cigarette, Cigar, and Cannabis Products at 12 High Schools — San Francisco Bay Area, 2018–2019

Abstract

The USA is experiencing an epidemic of lung injury associated with youth electronic cigarette (e-cigarette) use, or vaping; in 2018, 20.8% of U.S. high school students reported currently using e-cigarettes. E-cigarette products such as Juul, a popular device that delivers nicotine and flavors, are used by students at schools, including in classrooms and bathrooms. Use of flavored e-cigarettes by youths has become an increasing concern. A recent analysis of the National Youth Tobacco Survey showed that among high school students who currently used e-cigarettes, the percentage who used flavored e-cigarettes increased from 65.1% in 2014 to 67.8% in 2018. In 2018, 8.1% of high school students currently smoked cigarettes, and 45.7% of those students smoked menthol cigarettes. In addition, 7.6% of high school students currently smoked cigarillos, little cigars, or cigars, 43.6% of whom used flavored varieties of these products. Many youths also use cigars to make marijuana blunts (i.e., cigarillos with the tobacco removed and replaced with marijuana), and some use manufactured disposable cannabis products (e.g., vape pens, vaporizer cartridges, oils, and concentrates). Waste from e-cigarette products can contain plastics, nicotine, heavy metals, other chemical toxins, and hazardous lithium-ion batteries. The toxicity of combustible tobacco product waste from cigarettes (e.g., plastic cellulose acetate, nicotine, formaldehyde, lead, and cadmium) is well established. Cannabis product waste can include plastics, metals, electronic components, and batteries.