Hawaii health advocates are once again pushing for legislation banning flavored nicotine and vape products to protect youth from becoming victims of the harmful substance.
The Keiki Caucus backs House Bill 756, which prohibits the sale of flavored nicotine products as well as the mislabeling of e-liquids as nicotine-free in Hawaii. The Hawaii State Association of Counties supports House Bill 380, which gives counties back the authority to adopt their own laws regulating the sales of tobacco products and vapes.
“Here we go again,” said Pedro Haro, executive director of American Lung Association in Hawaii, referring to years of fruitless attempts. “What is different this year is county-level leadership are saying enough people have played with our youth’s health for way too long without any results.”
The state Department of Health called HB 380, which would allow counties to enact more stringent policies than the state, a health equity measure due to geographic disparities in smoking and vaping.
Another bill, House Bill 156 seeks to do the same, saying counties are uniquely positioned to address the health needs of their communities, and have done so in the past, such as raising the minimum age to buy tobacco to 21.
Many counties seek to ban flavored nicotine products, but in 2024, state bills proposing these measures failed.
Hawaii’s grades
The American Lung Association, meanwhile, gave Hawaii an “F” in a recent “State of Tobacco Control” report for its regulation of flavored tobacco products.
The report, ALA said, evaluates policies and effective laws proven to eliminate tobacco use and save lives.
For policies supporting smoke-free air, Hawaii got an A. For access to tobacco quitting services and state tax levels, Hawaii received B’s, and for funding of state tobacco prevention programs, the state received a C.
According to ALA, Hawaii has allotted about $8.1 million in state funding this fiscal year for tobacco control programs, which is 68% of the percentage recommended by the Centers for Disease Control and Prevention.
State tobacco-related revenue has brought in $112.2 million. But ALA estimates health care costs due to smoking in the state amount to $526.2 million. Smoking is attributable to more than 1,400 deaths per year.
ALA said Hawaii lawmakers should focus on ending the sale of all flavored tobacco products, including menthol cigarettes.
Haro is concerned about future versions of the bill carving out menthol, which he says will continue to addict kids because of its numbing and cooling effect, which masks the burning sensation of smoking and vaping.
“Here in Hawaii we are seeing tobacco industry lobbyists at the local level working to stop or weaken proven tobacco control policies,” said Haro.
County momentum
The Honolulu, Hawaii and Maui County Councils have all approved bills banning the sale of flavored tobacco products within their city limits. The Kauai County Council is considering similar legislation.
It’s time for counties to take the lead on tobacco again, according to Haro, who backs both bills.
“Every major piece of tobacco legislation we have in the state has started at the county level,” he said.
The state law preempting county rule was passed in 2018, nullifying any existing local ordinances or policies on the sales of cigarettes, tobacco products and e-smoking devices. It was added last-minute to another bill funding kidney dialysis centers, health advocates said.
The state Health Department testified that over the past decade, however, the vaping crisis in Hawaii has evolved and expanded to both younger and older age groups.
DOH said the latest estimates show that current use of e-cigarettes among high school youth is at 13.2%, down slightly from 14.8% two years prior, but that middle school e-cigarette use jumped significantly to 10.3% from 6.7% during the same time frame.
Anecdotally, DOH said, teachers have reported students vaping as young as second grade. On the other end of spectrum, an estimated 27.4% of adults ages 18 to 24 reported they are currently vaping.
“We have been coming here for over 10 years asking for restrictions on the sales of e-cigarettes,” said Lola Irvin, DOH administrator of chronic disease prevention, during live testimony. “Our 18- to 24-year-olds now are using e-cigarettes at a much higher level, so we’ve had an erosion of our tobacco prevention rates.”
The e-cigarettes have much higher nicotine content, she said, equal to three to four packs of cigarettes. The nicotine interferes with sleep, disrupts memory and accelerates mood disorders.
For and against
The bills have the backing of numerous organizations, including ALA, the state Health Department and the Coalition for a Tobacco-Free Hawaii Youth Council. The Youth Council provided a list of endorsements from more than 100 health care organizations, community groups, businesses, neighborhood boards and schools.
Individual middle and high school students testified in support of the bills, sharing stories of how flavored vapes harmed their friends and family.
The state Health Department testified that the fiscal impact of a ban on flavored nicotine products would result in modest reductions in Hawaii’s tax revenues while leading to reductions in chronic diseases and health care spending, including Medicaid spending.
The Youth Council testified that e-cigarettes have become “a deadly tool for profit in a worsening crisis of youth mental health.” With flavors like lilikoi lychee, luau punch and POG, the more than 15,000 e-cigarette flavors are designed specifically to entice local youth, the council said.
“Spending $26 million annually on marketing and hundreds of thousands on lobbying in Hawaii alone, the tobacco industry’s relentless presence in daily life on the islands isn’t an accident — it’s intentional,” said the council in written testimony. “Banning the sale of all flavored tobacco products would work to end this deadly cycle of addiction, manipulation, and exploitation.”
Health advocates also noted the tobacco industry is introducing new products that appeal to youth, with e-cigarettes that look like smartphones and flavored nicotine pouches, which are touted by social media influencers.
The ban of flavored nicotine is opposed by various individuals, small-business owners, ABC Stores and groups such as the Cigar Association of America and the Tax Foundation, both of which are based in Washington, D.C.
The Tax Foundation said in written testimony HB 756 likely would cost Hawaii more than $25 million in annual revenue and that illicit trade likely would increase substantially.
It said data from Massachusetts and California, which have statewide bans, show flavor bans are a costly and ineffective means of addressing harms associated with nicotine consumption. Additionally, banning flavored products “thwarts efforts to convert smokers to users of less harmful nicotine products.”
The Reason Foundation, a Los Angeles-based nonprofit think tank, expressed similar concerns and testified that the proposed ban “would promote further inequalities in the criminal justice system, and increase the illicit tobacco trade while failing to improve health.”
The House Committee on Consumer Protection and Commerce passed HB 380, reestablishing county rule, with amendments, Wednesday. The House Committee on Health and Homelessness passed HB 756, with amendments, Friday.
HB 156, which also would reestablish county home rule, has not yet been scheduled for a hearing.
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