Nearly half of all Hawaii high schoolers and a third of middle-schoolers have tried e-cigarettes, a Centers for Disease Control and Prevention report found.

The American Lung Association responded Friday to the report, saying the startling finding “punctuates the need for action” since severe lung illnesses and deaths are linked to vaping, and is “further compounded by the current COVID-19 crisis, making those with compromised lungs more vulnerable for the worst effects of this lung epidemic.”

The report shows in Hawaii 48.3% of high school students and 30.6% of middle school students have tried vaping.

Among high schoolers, 30.6% regularly vape, while 17.7% of their younger counterparts in middle school do. That’s up from 2018, when one in four high schoolers regularly vaped, a jump the American Lung Association calls staggering.

Among Native Hawaiians and Pacific Islander high schoolers, 39.5% report current e-cigarette use, nearly nine percentage points higher than the state average.

More than half of all Native Hawaiian and Pacific Islander high school students have tried e-cigarettes, while 45% of middle schoolers among those groups have.

“The elevated vaping numbers in Hawaii are disheartening, especially knowing that Native Hawaiians and Pacific Islanders have higher vaping rates than the rest of the youth in Hawaii,” said Pedro Haro, executive director of the American Lung Association in Hawaii.

The report was part of the CDC’s Youth Risk Behavioral Surveillance System, which monitors six categories of health-related behaviors that contribute to the leading causes of death and disability.

When asked why these populations of Hawaii students appear to have a higher percentage of tobacco and e-cigarette use, Haro said: “Certainly research has shown that when parents use tobacco it makes it more likely that their children will too.

“However, decades of research has also shown that tobacco companies have targeted communities of color through their advertising,” he said. “Advertising works, as we have seen the communities targeted by tobacco companies rise in rates of tobacco use.

“If you look at the vape shops that are based in Hawaii, they use imagery that is obviously targeted at our local youth. Even their retail locations are heavily concentrated in neighborhoods with the ethnic populations that are now showing the heaviest use of e-cigarettes.

“There’s no doubt that tobacco companies and e-cigarette retailers know exactly what they are doing. That is why it’s so important to counter their influence on the islands.”

One recent study shows that among young people tested for the coronavirus, those who vaped were five to seven times more likely to be infected with COVID- 19 than those who did not use e-cigarettes. That is according to a Stanford University School of Medicine study published online Aug. 11 in the Journal of Adolescent Health.

However, Haro said: “Right now, the Centers for Disease Control and Prevention is not calling e-cigarette use a risk factor in COVID-19, at least currently.

“There have been some studies that have shown the correlational relationship between e-cigarette use in youth and a positive COVID-19 screening, but it’s too early to tell what the relationship is between the two, if any.”

The American Lung Association in Hawaii is calling on the state Legislature to end the sale of all flavored tobacco products, including mint and menthol and all flavored e-cigarettes, cigars and cigarettes “to curb the youth e-cigarette epidemic.”

Despite Hawaii receiving $154 million from tobacco settlement payments and tobacco taxes, the state funding for tobacco control was a little over $6.3 million, or 57.5% of the CDC’s recommended level.

The American Lung Association’s “State of Tobacco Control” report called for proven tobacco control policies since the youth vaping epidemic has gotten worse in 2019.

In August, the Lung Association announced its revised Not On Tobacco youth tobacco cessation and Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health alternative to suspension programs and facilitator training courses.

N-O-T is an evidence-based program with a success rate of approximately 90% of participants cutting back or quitting tobacco.

For several years, these programs have been helping parents and teachers and youth themselves quit smoking and vaping.

The 2020 N-O-T program has been retooled so that people can be trained with the curriculum online while many work from home due to COVID-19, Haro said.

It includes all tobacco products, and increases focus on nicotine dependence, e-cigarettes and multiple tobacco product use.

“Our INDEPTH program is an alternative to suspension or a citation program that is offered as an option to students who face suspension for violation of school tobacco or e-cigarette use policies,” Haro said.

The Lung Association also has a website for parents at thevapetalk.org, which encourages parents to talk to their youth and gives them ideas on why and how to have that conversation.

The association also soon will be releasing more resources for youth, parents, schools and communities.

Haro added “our state needs to invest in helping youth quit tobacco, including e-cigarettes — as well as enact flavored tobacco restrictions.”

The N-O-T program evaluation “shows that along with quitting smoking or vaping, youth also have been shown to have better grades, higher motivation, fewer absences, better relationships with teachers and fewer school tobacco use policy violations,” he said.

Both programs support tobacco control policies in school or community settings and support the Lung Association’s measures to eliminate tobacco use by youth and to reduce the youth e-cigarette prevalence rate to 15% by 2025.