Lawmakers in Hawaii are considering a bill that would outlaw flavored tobacco products.
The flavors often come in liquid form and can be used in e-cigarette or vaping devices.
There are more than 15,000 flavors online, ranging from cotton candy to banana cream, according to data cited by health groups. Lawmakers say the packaging is deceptive and designed to look like Jolly Rachers or Sour Patch Kids.
Advocates for the flavors say they can help adults taper addictions to actual cigarettes, while critics argue they hook young people on nicotine, driving them toward real cigarettes.
If passed, the bill would make Hawaii the first state to ban flavored tobacco, though a number of US cities have passed these same type of measures.
Hawaii's legislature tried to ban flavored tobacco products in 2014, but that bill failed..
Advocates want to prevent kids from taking up smoking
Ahead of a hearing last month about the bill, the Hawaii Public Health Institute submitted a list of 120 organizations supporting the legislation as part of the #FlavorsHooksKidsHI campaign. The groups included the American Heart Association, the American Lung Association and the American Cancer Society Action Network, as well as the Hawaii chapter of the American Academy of Pediatrics.
The bill also enjoys support from the state's Department of Health, Department of Education and the Hawaii State Teachers Association.
In its written testimony, the state's health department argued that "the unprecedented youth vaping epidemic in Hawaii" poses seious public health risks. It cited a sixfold increase in vaping among middle school students and a sixfold increase among high school youth. That would put vaping rates among young Hawaiians at twice the national average.
"Those who use flavored tobacco products are more likely to progress to regular smoking," the study said, noting the growing scale of the global e-cigarette industry, now valued at over $10 billion.
Vaporizing an industry
Purveyors of tobacco and electronic cigarettes were opposed to the measure. Cory Smith, who runs Volcano Fine Electronic Cigarettes, wrote to the committee that his company was the largest retailer and wholesaler of vapor products in the state, and argued that the bill would "decimate" the Hawaii vapor industry.
Smith wrote that e-cigarettes don't contain actual tobacco, so therefore "every electronic cigarette available on the worldwide market is 'flavored,'" and even the e-cigarettes advertised as having a basic "tobacco flavor" had to have that flavor synthetically added.
He said the bill was a "de facto ban of the manufacture and sale of all electronic cigarettes."
Though health groups largely argue that flavored e-cigarettes are a gateway drug for young people into more dangerous nicotine products, Smith argued they can have an opposite effect in long-term adult smokers.
He cited a recent study published in the International Journal of Environmental and Public Health, in which 49% of adults surveyed told researchers that removing flavors would increase their cravings for actual cigarettes.
In his letter, Smith told the committee the bill would hurt adults who'd cut their smoking habit, and "decrease their chances of remaining abstinent from smoking."
The FDA is looking at similar measures
Last November, Food and Drug Administration Commissioner Scott Gottlieb announced federal-level plans aimed at preventing a new generation from getting addicted to nicotine. He said the FDA wanted to "combat youth access and appeal with a policy framework that firmly and directly addresses the core of the epidemic -- flavors."
He stopped short of pushing for an outright ban on flavors, but advocated sweeping restrictions in how and where the products are sold. Gottlieb's plans call for electronic nicotine delivery systems to be sold only in age-restricted, in-person locations that prevented those under age 18 from entering. That proposal would also apply to e-liquid flavors like cherry and vanilla.
But the FDA would allow a carve-out around mint and menthol flavors for adults who relied on these basic flavors to moderate addictions to actual cigarettes. According to Gottlieb's announcement, "This distinction among flavors seeks to maintain access for adult users of these products, including adults who live in rural areas and may not have access to an age-restricted location, while evidence of their impacts continues to develop."
While tamping down on the more enticing flavors, the FDA's framework would continue to monitor research on whether the mint and menthol flavors also contribute to rises in youth smoking.
Hawaii has a recent history of progressive 'firsts'
But Hawaii's bill shows many in the state aren't willing to wait for Washington. Valerie Chang, who heads the Hawaii COPD Coalition, offered written testimony to the committee: "We know rule-making at the federal level often takes a long time, which is why state-level action on menthol and other flavored products is needed now."
Being isolated in the Pacific, and with a small, predominantly liberal population, Hawaii has emerged as a testing ground for a range of progressive policy experiments. It was the first state to raise the legal smoking age to 21. And because Hawaii is particularly vulnerable to climate change and rising sea levels, lawmakers made it the first state to commit to the goals of the Paris climate accord and banned certain types of sunscreen to protect Hawaii's coral reefs. They also committed to using only renewable energy by 2045.
Joshua Stanbro, Honolulu's chief resilience officer, told CNN, "When you are in an island, you can't run away from your problems."
And it's not even the first time this year lawmakers have swung for the fences against tobacco.
Earlier this year, Rep. Richard Creagan proposed a bill that would have raised the age to buy cigarettes in the state to 100, effectively banning them. His bill proved too ambitious in committee, though, and didn't advance to a floor vote.