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Research has shown that harmful chemicals leached from discarded butts, which include nicotine, arsenic and heavy metals, can be acutely toxic to aquatic organisms. A 2011 study by San Diego State University suggested that the chemicals leached from one smoked cigarette butt were capable of killing half of the fish present in a one-litre bucket of water, while researchers at the UKs Anglia Ruskin University found cigarette butts significantly hindered the growth of terrestrial plants

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19 Commonly reported oral symptoms include xerostomia, burning, pain, oral ulceration, nicotine stomatitis, hairy tongue and angular cheilitis Poor-quality evidence exists with regard to oral symptoms pertaining to ENDS, usually because the data are self-reported