Hawaii Attorney General Anne Lopez has joined a multistate coalition urging the Biden administration to move forward on its ban of menthol cigarettes and flavored cigars.

Lopez on Tuesday submitted a letter, along with 20 other attorneys general, urging the administration to finalize its review of proposed rules to prohibit the sale of the products. The proposed FDA rules are “supported by ample evidence” and long overdue, the Department of the Attorney General said.

The attorneys general said swift action to ban menthol is needed to save lives and prevent disease, particularly among youth and certain racial ethnic minorities, including Black Americans.

“Flavored tobacco products continue to pose significant threats to public health in Hawaii,” said Deputy Attorney General Ashley Ta­naka of the department’s Tobacco Enforcement Unit in a news release. “Menthol cigarettes, in particular, create age, gender, and racial disparities in Hawaii as they are disproportionately used by youth, women, and certain ethnic groups including Filipinos, Native Hawaiians, and Japanese.”

The ban is supported by the NAACP, Campaign for Tobacco-Free Kids, American Heart Association, American Lung Association and American Cancer Society.

“We join their call for action and urge the (Office of Management and Budget) to finalize its review of the rule without delay,” the letter said, adding that any claims the ban will increase illicit trade or criminalize the individual purchase or use of menthol cigarettes are unfounded.

In April 2022, the U.S. Food and Drug Administration released its proposed rules to ban menthol cigarettes and flavored cigars, with the goal of preventing children from becoming the next generation of smokers and helping adult smokers quit.

The FDA said published modeling studies show the ban could potentially prevent an estimated 324,000 to 654,000 smoking-attributed deaths over 40 years.

But in December, White House officials decided to take more time to review and implement those rules, the Associated Press reported.

The move comes as local health advocates prepare once again to push for a statewide ban of flavored tobacco products at the state Legislature, or the right for counties to do so at the municipal level.

Hawaii health advocates say that mint- and menthol- flavored tobacco products are heavily marketed to kids, especially those from communities of color.

In 2021 approximately 70.5% of adults and nearly 16% of teens in Hawaii smoked menthol cigarettes, according to Hawaii Health Matters.

“We definitely applaud the attorney general for signing onto this,” said Pedro Haro, executive director of the American Lung Association in Hawaii. “We are encouraging our own delegation to contact the Biden administration to adopt the policies.”

The lung association supports state Legislature bills that “once and for all ban all flavors, including menthol” from tobacco products being sold in Hawaii, he said, or give counties back the authority to enact their own regulations on tobacco products.

The Honolulu City Council in October passed a measure to prohibit the sales of flavored tobacco products, which would only take effect if a state law stripping counties of that authority is overturned.

Tobacco companies use menthol to mask the harsh taste of chemicals in cigarettes and cigars, according to Haro, due to its numbing effects.

“When somebody first starts smoking or vaping, their system is not used to it so the menthol helps make it more palatable,” he said. “That’s why to end the youth epidemic, eliminating menthol as a flavor will allow people to really feel the full consequences of vaping and smoking.”

The FDA says menthol also interacts with nicotine in the brain to enhance nicotine’s addictive effects.

Lopez signed the letter along with the attorneys general of Arizona, California, Connecticut, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Northern Mariana Islands, Oregon, Pennsylvania, Puerto Rico, Rhode Island and South Dakota.