State lawmakers, grappling with how to stop an unprecedented rise in vaping among Hawaii youth, will consider a statewide ban of flavored electronic cigarettes again next legislative session amid a growing outbreak of lung illnesses nationwide.

As of Tuesday there were 33 deaths and 1,479 cases of lung injuries linked to vaping in all states except Alaska, according to the Centers for Disease Control and Prevention. Hawaii has at least two reported cases.

“I would personally like to ban all of the sale of e-cigarettes,” said Sen. Roz Baker (D, South-West Maui), following a Thursday legislative briefing seeking solutions to end the “youth vaping epidemic.” “The other thing is to increase the taxes because it’s clear that the youth population is sensitive in that regard.”

Hawaii has the second- highest cost in the nation for a pack of cigarettes at an average $8.99, with the state excise tax at $3.20 and sales tax of roughly 35 cents per pack, according to SalesTaxHandbook.com. Baker plans to push for an e-cigarette tax equivalent to tobacco.

Earlier this year legislators killed a bill that would have made Hawaii the first state in the nation to ban flavored e-cigarettes. Also on Thursday, electronic cigarette maker Juul Labs announced it would stop sales of most vape flavors, except menthol.

Scott Stensrud, the statewide youth coordinator for the Coalition for a Tobacco-Free Hawaii, who attended the briefing, said that like tobacco, the e-cigarette industry is targeting lower-income minority populations in the state.

“They’re using the same playbook right out of big tobacco,” he said. “Specifically with menthol, if you go through communities where there’s high percentages of Native Hawaiians and Filipinos, you’ll see more of the menthol ads out there. If you look at some of the old tobacco (ads), they targeted certain populations that back in the day were the laborers, people that were out in the hot sun, because the menthol had a cooling effect.”

Hawaii ranks second in the nation for e-cigarette use among high school students, with an estimated 25.5% currently vaping, twice the national average, according to Health Department statistics. E-cigarettes are even more prevalent on the neighbor islands, with as many as 34% of high school students using the devices.

“We’ve got a quarter in schools vaping. It’s a bad situation all around, and we’re dealing with it as best we can, trying to educate teachers and parents,” state Health Director Bruce Anderson told lawmakers. “We got a lot of work to do; there’s no silver bullet.”

Samantha Domingo, a 17-year-old senior at Farrington High School and member of the Hawaii Public Health Institute Youth Council, said many of her peers believe e-cigarettes are a safer alternative to tobacco. She speaks at different middle schools about the dangers of vaping.

“They’re not aware of all the dangers and harmful effects. This issue is very personal for me because I know people my age sell e-cigarettes and e-juice, and they have connections to people who will sell to kids,” she said. “It’s difficult (for them to stop) because they’re attached to their devices, and I don’t think a simple talk will make them change their minds.”

Dr. Bryan Mih, a local pediatrician and medical director for Kapiolani Smokefree Families, a cessation program at Kapiolani Medical Center for Women &Children, said kids’ brains are being adversely affected by the high doses of nicotine found in e-cigarettes, which can disrupt attention and learning, cause mood swings and worsen impulse control.

“It is not safe in the lungs. It can be lethal as well. One container can kill a toddler-size child,” Mih said. “With regular smoking we waited for half a century before we were able to get all the rules in place to improve everyone’s health. With vaping we’re seeing the very tip of the iceberg. We have to stop it now before it becomes an even bigger problem.”