In light of all the recent media coverage about the rising popularity of e-cigarettes — also known as electronic smoking devices — the Hawaii Public Health Association (HPHA) calls upon the community to consider this enterprising newcomer to the tobacco world with great skepticism and wariness.

In order to protect the health of our state, as well as that of future generations, a precautionary stance should be taken in policy and public education regarding the product.

The HPHA would like to add some key thoughts to the current discussion about whether e-cigarettes should be regulated.

» First off, packaging and labeling standards are nonexistent. For safety reasons, this is a red flag that needs to be addressed urgently to protect keiki in Hawaii.

» Second, while appetizing flavors may appeal to adults, they are especially attractive to youth. How can flavoring be regulated to safeguard the products from alluring youth in particular?

» Last, because the e-cigarette industry is not subjected to the laws that restrict advertising of traditional or combustible cigarettes, aggressive marketing is occurring and young people are regularly being influenced by these messages.

E-cigarette marketing should be held to much stricter standards regarding messaging claims and youth exposure than is currently the case.

This year marked an important milestone in public health: the 50th anniversary of the 1964 surgeon general’s report warning of the health hazards of smoking.

The latest iteration of the report highlighted the dramatic progress our nation has made in reducing tobacco use, as well as described the ongoing burden of disease and death caused by smoking today.

The authors of the report also addressed what they referred to as "the end game" — or achieving a vision of a society free of tobacco-related death and disease.

If the public health community in Hawaii is to embrace the "end game," perhaps new noncombustible products such as e-cigarettes should be among the first considerations.

In light of recent reports and media coverage, let us recognize them as threats to all the progress that we’ve made over the last 20 years.

Novel products such as e-cigarettes threaten to undermine these gains and lure kids into an addiction to nicotine. According to the Centers for Disease Control, nicotine use by youths in any form is unsafe and can harm adolescent brain development.

As a community desiring better health outcomes for our young people than was possible for our parents, let us proactively and responsibly consider stronger regulation of the products going forward in 2015.

In light of what is known about these products, the HPHA does not endorse electronic smoking devices as safe alternatives to combustible tobacco products.

As leaders in public health, the Hawaii Public Health Association supports policies that prohibit use of electronic smoking devices where smoking is prohibited.

It also recommends other regulations that consider the potential adverse impacts of the use of electronic smoking devices on the entire population, especially children and nonusers.