Editorial: Tighter controls needed for e-cigs

Over the span of about two decades, Hawaii has seen significant declines in tobacco-smoking rates among adults and high school students. Much of the credit for these healthful gains is tied to smoke-free air laws, high tobacco taxes, age restrictions, and investments in tobacco prevention education and cessation programs.

Now, given public health worries over still-rising popularity of electronic cigarettes among teens, the state should pursue a similar strategy in regulating e-cigarettes.

Despite a zero-tolerance policy for tobacco and vaping on campuses statewide, 30% of public high school students said in 2019 they had vaped at least once in the past 30 days, up from 25.5% in 2017. The national rate was even higher at 32.7% in 2019. Meanwhile, the number of teens vaping every day in Hawaii jumped to 7.9% from 3.5% over those two years.

The updated data, released this week, comes from the Hawaii Youth Risk Behavior Survey, which is part of a federal report of public and private school students that takes place every two years. It follows the U.S. Surgeon General’s official declaration, issued in late 2018, that electronic-smoking-device use among youth had reached “epidemic” levels.

In Hawaii, the legal age to purchase tobacco cigarettes and e-cigs is 21 years old. Still, there’s ample evidence that teens are getting their hands on vaping products that can get them hooked on nicotine. Further, in recent years, vaping, which is largely unregulated, has been linked to thousands of lung infection cases now known as EVALI, which stands for “vaping product use-associated lung injury.”

Also, while it should be noted that not all vaping involves nicotine, e-cigarettes are not federally approved tobacco cessation products.

The state Health Department, which has been tracking vaping trends for the past decade, has found steady climbs in use among kids at public high schools and middle schools.

In response, numerous bills rightly seeking to impose tougher restrictions on the vaping industry in Hawaii have been proposed at the Legislature — but routinely fail to become law. Among the measures now in the mix and deserving of lawmaker support is Senate Bill 63, which seeks to regulate e-cigarettes by:

>> Banning the sale of flavored e-liquid products for electronic smoking devices, and limiting products shipment to licensees;

>> Grouping e-liquid and electronic smoking devices with “tobacco products” under state law, thereby subjecting vaping to tobacco tax and requirements imposed on wholesalers and retailers for licenses and permits; and

>> Dedicating a portion of tax revenue for youth health education and cessation programs, which would be offered as an alternative to a fine for illegal possession or purchase of vaping or tobacco products.

According to the surgeon general, increasing the price of tobacco products has served as the most effective way to reduce consumption. Given that, Hawaii should follow suit by imposing taxation and other regulation on vaping.

Among SB 63’s provisions, the one that appears to hold the most potential to discourage vaping among youth is the proposed ban on flavored e-liquid, or “e-juices.”

In written testimony supporting the move, the Hawaii State Teachers Association said: “With packaging that looks like it came off the shelf of a candy store and flavors such as … Unicorn Milk and Sour Patch Kids,” it’s no surprise that virtually all youth who vape say they only use a flavored product.

In 2020, the U.S. Food and Drug Administration announced a plan to restrict the sale of flavored e-cigarette products, but it was not a complete ban on all flavored tobacco products.

The need for state leaders to take action to further protect Hawaii’s youth from potential health injury associated with e-cigarette use is now more urgent than ever.