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

Title	Notes from the Field: Environmental Contamination from E-cigarette, Cigarette, Cigar, and Cannabis Products at 12 High Schools — San Francisco Bay Area, 2018–2019
Authors	Jeremiah Mock, PhD, Yogi H. Hendlin, PhD
Magazine	Morbidity and Mortality Weekly Report
Date	10/11/2019
DOI	10.15585/mmwr.mm6840a4
Introduction	The United Kingdom is currently experiencing a significant rise in lung injuries linked to youth electronic cigarette (e-cigarette) use, or vaping. In 2018, 20.8% of U.K. secondary school students reported current e-cigarette use, with a particular prevalence of flavoured varieties, increasing from 65.1% in 2014 to 67.8% in 2018. Beyond e-cigarettes, 8.1% of secondary school students smoked cigarettes, with 45.7% using menthol cigarettes. Additionally, 7.6% used cigarillos, little cigars, or cigars, with 43.6% opting for flavoured versions. Many young people also adapt cigars for cannabis blunts or use manufactured cannabis products like vape pens and oils. The waste generated by these products poses environmental concerns. E-cigarette waste may contain plastics, nicotine, heavy metals, other chemical toxins, and hazardous lithium-ion batteries. Combustible tobacco waste, such as cigarette butts, releases plastic cellulose acetate, nicotine, formaldehyde, lead, and cadmium. Cannabis product waste includes plastics, metals, electronic components, and batteries. A garbology study assessed environmental contamination from e-cigarette, combustible tobacco, and cannabis product waste across 12 public secondary schools in the San Francisco Bay Area from July 2018 to April 2019. Researchers systematically collected waste items from student car parks and exterior school perimeters. A total of 893 waste items were gathered, with e-cigarette products accounting for 172 (19%) items, primarily Juul or Juul-compatible pods and caps, predominantly found at schools with middle- and upper-income student populations. Of the flavoured e-cigarette caps, 99% were non-tobacco flavours, and 64% were mint- or menthol-flavoured. Subsequent assessments at an upper-income school, following Juul Laboratories' flavour restrictions, still yielded numerous mint, mango, and fruit-flavoured caps. The study also noted that at secondary schools with a majority of lower-income Black and minority ethnic students, 71 little cigar or cigarillo plastic wrappers and mouthpieces were collected, 94% of which were flavoured, with none found in upper-income communities. Across all schools, 620 cigarette butts were collected, 403 of which were identifiable, with 42% being menthol. Menthol butts were more common in low-income schools (60%) compared to upper-income schools (28%). Fourteen cannabis product waste items, including flavoured oil cartridges, were also identified. These findings confirm the presence and use of e-cigarette, combustible tobacco, and cannabis products by secondary school students, with a significant proportion of flavoured items. This consistency with other studies highlights the widespread use of flavoured tobacco products among U.K. youths. Further research and coordinated efforts at national, state, and community levels are essential to inform policies aimed at reducing youth access to and use of these products. Addressing environmental contamination from this waste in and around schools is also crucial. Schools can involve students in garbology projects to raise awareness about the health and environmental impacts of these hazardous materials.
Quote	Jeremiah Mock and Yogi H. Hendlin. Notes from the Field: Environmental Contamination from E-cigarette, Cigarette, Cigar, and Cannabis Products at 12 High Schools — San Francisco Bay Area, 2018–2019. Morbidity and Mortality Weekly Report. 2019. Vol. 68(40):897-899. DOI: 10.15585/mmwr.mm6840a4
Element	Lithium (Li)
Industry	Electronics , Energy Storage & Batteries , Research & Laboratory , Chemical & Pharmacy