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What defines

doi: 10.1155/2012/898053

These distributions show pronounced variability, suggesting that although many places report minimal contamination, cigarette butts can accumulate at substantial levels in some other areas

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Nevertheless, a significant number of biomarker-based studies, cell/ in vitro and animal studies did indicate that e-cigarette exposure can result in oxidative stress, cellular apoptosis, DNA damage, genotoxicity, and tumor growth (Figure 2, and Supplementary file Materials 2 and 3), all of which can potentially increase risk of developing lung cancer or progression of any cancer

This is called dual or poly tobacco use, and it can last for a long time