POG, li hing, guava, lilikoi passion, mango lychee, Hawaiian mint, Hi-Drip honeydew, luau punch and passion orange. No, these are not flavors of fruit snacks or candies found at Long’s, but flavors of nicotine/tobacco products that are marketed directly to our keiki.
Most of the youth using nicotine are doing so through flavored e-cigarettes, also known as vapes. These e-cigarettes have a tremendous amount of nicotine, as much as what is found in at least two packs of cigarettes. Youth begin using nicotine because of the flavors and marketing but then continue to use because of the high levels of nicotine.
In fact, many youth have become addicted to e-cigarettes, and are struggling to quit. The latest data from the Hawaii Department of Health show that 32% of Hawaii high school students have ever vaped nicotine, with 13.2% having used in the past month. Native Hawaiian and Pacific Islander youth are disproportionately affected by e-cigarette use. We must stop the sale of these flavored nicotine products to protect our keiki.
Born and raised in Hawaii and with deep ties to the community, Carly has observed these harms directly on Hawaii’s youth through close collaboration with community partners. Both Carly and Dr. Halpern-Felsher, a professor and developmental psychologist studying youth tobacco use, have discussed concerns about youth use of nicotine with many educators and youth in Hawaii.
We have firsthand knowledge of youth use of these flavored nicotine products and the harms they cause, including addiction, asthma, lung collapse, heart disease and other issues. Almost daily, educators email us desperately trying to find ways to help prevent, reduce and stop youth use of nicotine/tobacco products.
Given concern over so many youth vaping in Hawaii, we collaborated with the Hawaii Community Foundation and many educators and youth to create a Hawaii-specific version of our You and Me, Together Vape Free Curriculum, which is part of our Tobacco Prevention Toolkit.
We have reached more than 54 schools, 2,047 educators and youth programming staff, and well over 5,608 students through our curriculum.
There are thousands of unique e-cigarette flavors, and numerous flavors in other tobacco products including cigars/cigarillos, smokeless tobacco and hookah. Flavors including mint and menthol attract young and new users.
Despite historic tobacco industry claims that menthol simply adds flavor, tobacco industry documents have revealed that the industry manipulates menthol levels to control a cigarette’s intensity to cater to new and long-term smokers. Young smokers (12-17 years of age) are three times as likely to smoke menthol cigarettes than smokers 35 years and older.
Most youth cite flavors as a reason for use and report they would not start and even quit using if flavors weren’t available. If flavors for one tobacco product aren’t available, youth will simply switch to another flavored tobacco product.
Hence, the only way to fully protect our keiki is to have a comprehensive flavor ban that includes all tobacco/nicotine products and all flavors, including menthol, mint and ice flavors.
Flavors mask the risks that are inherent in tobacco and nicotine products, including the alarmingly high amount of nicotine that is particularly harmful for growing youth.
Given that our brains and lungs continue to develop until the mid-20s, any tobacco and nicotine product that we introduce into our bodies can be harmful. Further, due to brain development, youth are significantly more likely to become addicted to nicotine than adults, thus making it imperative that we get tobacco/nicotine out of the hands of kids.
We MUST do everything we can to prevent tobacco/nicotine use, especially among our keiki. Supporting House Bill 756 and prohibiting all flavored tobacco products, including menthol, will help do this.
Dr. Bonnie Halpern-Felsher is the Marron and Mary Elizabeth Kendrick Professor in Pediatrics II at Stanford University and founder of the Stanford REACH Lab; Carly Noelani Kajiwara is director of educational trainings in the REACH Lab.
