The irony of the alarming vaping statistic for Hawaii is that while the state has one of the lowest rates of smoking — fourth lowest nationally — the rate of e-cigarette use is high. The islands appear to have conquered one vice while starting to succumb to another.
And now that outcome has left Hawaii in a dangerous position. Increasingly, the practice of e-cig “vaping” has led to lung ailments and even fatalities. Patients with a serious lung illness linked to vaping have been identified nationally, including users of the products in the islands.
The call has sounded for a much more aggressive intervention by state lawmakers and other officials. Vaping has become more common among Hawaii youth, with more than a quarter of middle schoolers and 42% of high school students saying they’ve at least tried e-cigs.
And this means a looming health crisis can only grow even worse, as more and more kids become hooked.
Encouragingly, the state has begun some work on improving on public education and is pursuing other avenues as well.
Gov. David Ige said last week there are no plans for an emergency ban of products, such as a few states have announced. That seems reasonable, given that much of e-cigarette sales happen online, beyond a state’s reach.
And after a consultation with the Office of the Attorney General, the state is unlikely to embargo any products until authorities have identified a specific substance as a cause of the illnesses, said Department of Health Director Bruce Anderson.
The Centers for Disease Control has not yet singled out any particular substance as the cause of the illnesses.
On Friday, however, that federal agency did update its guidance, recommending against the use of vaping products containing tetrahydrocannabinol (THC), the psychoactive ingredient in cannabis.
It also has issued a more general caution against those products containing nicotine. And vaping is especially discouraged for anyone suspected of having an associated lung injury, according to the CDC.
The litigation strategy also is being studied, said Attorney General Clare Connors — as it should be. There could be settlement funds to be secured if the state joins with one of the legal complaints filed against the industry’s major manufacturers.
In many ways, this would replicate the course this state followed more than 20 years ago, when it was part of a lawsuit against cigarette manufacturers that yielded a settlement and an ongoing revenue stream for Hawaii. This is what paid for the anti-smoking campaign of the 1990s, Connors said, a public education effort that successfully drove down the state’s smoking rate.
That was a hard-won improvement in public health that should not be sacrificed by surrendering to the vaping epidemic, or by mounting only a weak offensive against it.
Fortunately, DOH has committed to combatting the new habit before it takes hold any further, especially among Hawaii’s youth. Anderson, who also served as health director during the administration of Gov. Ben Cayetano, was in the thick of the anti-smoking campaign and rightly believes a similar approach could work again.
Legislators should seek available funds for public education when it convenes in January, but the agency can’t wait for that. Existing funds are being tapped for initial outreach efforts.
Lola Irvin, administrator for the DOH division for chronic disease prevention and health promotion, said these include training for school teachers and administrators, as well as nonprofit staffers who work with kids, on the best way to deter e-cig use among the young.
Also, some digital advertising already has begun. The ads are aimed at giving adolescents messages countering the promotions that now target youths through smartphone apps, Irvin said.
Providing tools to those on the front lines of this battle could be the most effective use of limited funds, if the programs are well run. This effort needs to be ramped up quickly.
At the state Capitol last session, a push to enact sensible legislation stalled. A bill that sought to encourage school confiscation of e-cigs through an increase in the fine against the students was passed but then vetoed.
Because the devices are small and often difficult to detect, the better bill may have been one restricting the way the products are positioned for, and marketed to, children. Sweet flavorings are among these tactics. Lawmakers should take another look.
What should not be forgotten is the mistake made allowing these products on the market in the first place without careful study. Recent New York University research indicates that e-cig vapor causes cancer and other ailments in mice. Further study is needed before it’s pushed on more humans than are already inhaling.
For the present, it appears that the best short-term action is to ramp up the public outreach and the messaging — the message being, “Vaping is hazardous to your health.”
