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However, more research is needed to fully understand emissions from e-cigarettes and their impact on human health. These aerosols can contain potentially harmful substances — including nicotine, formaldehyde and metals — some of which cause cancer and other harmful health effects. Some e-cigarette brands and other nicotine products state they contain synthetic nicotine rather than nicotine made from or derived from tobacco.

There have also been cases of e-cigarettes exploding or catching fire. Some chronic users have developed obstructions in their lung pathways that cause them to suffer 'asthma-like' symptoms. Similar to Wyoming, the state's vast rural areas might contribute to difficulty enforcing regulations surrounding youth vaping. West Virginia came in second place, with 28 percent of teens vaping last year. The large rural area may make it more difficult to enforce the state's vaping laws. Rural areas also tend to have less access to clinics and resources about the health harms surrounding vaping.

With millions of teens and young adults using e-cigarettes, a new generation could become addicted to nicotine and face other health risks. For some adult smokers, e-cigarettes may offer a less harmful substitute for traditional cigarettes. However, long-term effects on users, second-hand exposure, and environmental effects are not yet fully known. The e-liquid typically contains humectants and flavourings, with or without nicotine