Hawaii received an “F” grade for its policies on flavored tobacco products, according to the American Lung Association’s annual State of Tobacco Control report.
Hawaii received mixed results in other categories, including a “C” for tobacco prevention and control program funding, a “C” for tobacco taxes, a “B” for access to cessation services, and an “A” for smokefree air.
“As a state, we have a history of being revolutionary about tobacco control,” said Pedro Haro, executive director of the American Lung Association in Hawaii, who noted Hawaii was first state to legislate smoke-free beaches and raise the minimum age of purchase to 21. “When vaping came along, it sort of threw everything for a loop, and I think it’s time to adopt our old ways of being really vigilant about tobacco control.”
New bills introduced in the Legislature by both the state House and Senate would ban the sale and possession of flavored tobacco products.
In addition to flavors like “Shaka Strawberry” and “Lychee Ice” mentioned in the bills, the ban also would include menthol products.
The 2021 Youth Risks Behavior Survey, a report by the Department of Health and Department of Education, found that 59% of high schoolers and 38% of middle schoolers that smoke used menthol products.
“It’s time to take action,” said Rep. Nicole Lowen of Kailua-Kona, a co-introducer of the House bill. “There’s clear benefits that come from implementing these policies in terms of reducing tobacco use among youth, and I think the benefits we see supersede some of these desires for adults to have a flavored tobacco product.”
A similar bill was introduced last year and vetoed by former Gov. David Ige after amendments exempted several products.
“The amendments basically allowed flavored tobacco products that were seeking an exemption from the FDA to stay on the market,” said Haro. “It would have virtually removed no products from any shelves across Hawaii.”
Tobacco Free Kids reported that tobacco companies spent nearly $350,000 on campaign contributions in Hawaii since 2014 and $24 million annually on marketing. The numbers are notably less than the $526 million in annual health costs in Hawaii tied to smoking referenced in the bill.
“Tobacco industry lobbyists are still incredibly active,” said Haro. “It’s a lucrative industry, and they continue to donate into our local politics.”
Another report, the 2021 National Youth Tobacco Survey, estimated that ending the sale of flavored tobacco in Hawaii could save roughly $48 million in long-term health care costs, prevent 700 premature smoking-related deaths, prompt over 3,000 menthol cigarette smokers to quit, and prevent youth from initiating smoking via menthol cigarettes.
Flavored tobacco products also are tied to a recent rise in smoking rates among youth in Hawaii.
“The flavors are what hook kids into vaping and smoking,” said Peggy Mierzwa, director of policy and advocacy at Hawaii Public Health Institute. “Statewide and in every county, it has been going up.”
According to the bills, 81% of youth statewide who have used a tobacco product reported experimenting with a flavored product first.
“Predominantly, the vapes are candy flavored, so they’re not feeling like they’re smoking a cigarette,” said East Hawaii Drug Free Coalition Coordinator Sally Ancheta, who added a vape can contain as much as 30 cigarettes worth of nicotine. “When kids would traditionally try a cigarette it would burn, they would cough, and feel nauseous. But with vaping, there’s really no deterrent.”
The Youth Risks Behavior Survey also noted in Hawaii County, roughly 37% of high school students reported smoking on a regular basis, while over 56% had tried vaping.
“Keep in mind we don’t collect population data at the elementary school level,” said Ancheta. “We just had our monthly Tobacco Free Hawaii Island meeting, and it was reported to us that youth as young as first grade right now are getting caught or being acknowledged as vaping in elementary school.”
A precedent for a flavor ban has been set by five other states — California, Massachusetts, New Jersey, New York and Rhode Island..
If passed, the measures would take effect on Jan. 1, 2024, and any retailer would be fined between $100 and $1,000 for a violation, with fines going toward the general fund.
Additional bills being proposed this year to mitigate tobacco use include raising the legal age of purchasing and possession from 21 to 25, increasing the cigarette tax stamp fee, criminalizing the unlawful shipment of tobacco products, and reauthorizing counties to enact restrictions on the sales of tobacco products, including vapes.
“A lot of the progress in the past has been done at the county level, but unfortunately, because of the way the laws are written now, there are restrictions on what the counties can and cannot do around tobacco,” said Haro. “The middle ground is perhaps allowing the counties to once again enact these policies on a county-by-county basis, because it is a trial for the rest of the state.”
For those ages 13 and older looking to quit their vaping habits, help is available at: hawaii.mylifemyquit.org.
Email Grant Phillips at gphillips@hawaiitribune-herald.com.
