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E-cigarette waste is potentially a more serious environmental threat than cigarette butts since e-cigarettes introduce plastic, nicotine salts, heavy metals, lead, mercury, and flammable lithium-ion batteries into waterways, soil, and to wildlife. "Nicotine analogs are currently not subject to the FDA process and have not been studied for their health effects," Jabba said. This data brief dives deeper into rural youth tobacco use in Minnesota.

Moreover, we just don’t know the long-term effects of vaping," said Dr. Bhavna Barmi, a senior clinical psychologist. Vaping, still at epidemic levels among youth with about one in five high school students using e-cigarettes in 2020, generates a significant amount of toxic and plastic waste. Many popular e-cigarettes, like JUUL, are pod-based with single-use plastic cartridges containing nicotine. Generating even more waste are disposable e-cigarettes like Puff Bar, which are designed entirely for one-time use and have skyrocketed in popularity with a 1,000% increase in use among high school students between 2019 and 2020. Nicotine exposure during adolescence can affect learning, memory, and attention. It can also increase risk for future addiction to nicotine and other drugs.

Youth ENDS use raises concerns about nicotine addiction, negative effects of nicotine on adolescent brain development, and other potential health harms, including increased risk of initiating cigarette smoking. Electronic nicotine delivery systems (ENDS), also called electronic cigarettes, e-cigarettes, vaping devices, or vape pens, are battery-powered devices used to smoke or "vape" a flavored or unflavored solution which usually contains nicotine. The American Academy of Family Physicians (AAFP) recognizes the increased use of ENDS, especially among youth and young adults, as well as its use by those attempting to quit smoking tobacco. Although e-cigarettes do not contain tobacco, for regulatory purposes, they are considered "tobacco products" by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). E-cigarettes can go by different names, including vapes, vape pens or sticks, e-hookahs, hookah sticks, mods, and personal vaporizers.

However, to date, no e-cigarette product has been approved by the FDA for quitting smoking. Although e-cigarettes have been sold in the U.S. for nearly 20 years, use patterns have shifted dramatically. As newer iterations brought higher levels of nicotine in an increasing array of flavors and product designs, youth use skyrocketed.

Research has also shown flavor chemicals to be toxic in both e-liquid and aerosol form. While many flavor chemicals used in vaping products have been approved for ingestion, they have not yet been tested for safety when aerosolized. Flavor chemicals are typically not listed on e-cigarette packaging, and most e-liquids contain more than one flavor chemical. Benzaldehyde (used in cherry-flavored products) and 2, 5-dimethyprazine (used in chocolate-flavored products), specifically, may harm human health.

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