������Ƶ

On Feb. 8 ������Ƶ published an article entitled, “Hawaii Lawmakers consider high taxes for e-cigs,” with the subheading, “The vaping industry worries that 70% tax hikes could kill businesses.”

As health professionals representing academic, governmental, and non-profit sectors, we were concerned by the content of this article. We would also like to call attention to the need to carefully vet sources when writing stories about tobacco and electronic nicotine devices.

The article described efforts by Rep. Scot Matayoshi to pass a bill that would increase taxes on electronic smoking devices and e-liquid products in an attempt to achieve tax parity with cigarettes and other nicotine products. The author explained that the bill “aims to reduce negative health effects among the community by making vaping more expensive.”

She did not elaborate on how such efforts are believed to reduce electronic nicotine devices use, who in our community most uses these products, or the evidence behind such legislative efforts.

The rest of the article focused on the perspectives of those in opposition to the bill, including a 30-year-old sitting outside a coffee shop, a representative from R Street Institute, and one from VOLCANO eCigs. Other than Rep. Matayoshi, who is championing this bill, the views of those in favor of the bill or suggesting modifications to it were missing.

This is surprising given that a quick review of testimony about the bill would have identified numerous organizations with important insights to nuance and balance this article: Campaign for Tobacco Free Kids, American Heart Association, Hawaii COPD Coalition, Hawaii Public Health Institute, Hawaii Primary Care Association, Hawaii Independent Association of Schools, Hawaii Substance Abuse Coalition, Hawaii Public Health Association and Hawaii Children’s Action Network.

Given that the overall objective of the bill is to reduce the negative health effects associated with electronic nicotine device use, it is surprising that the article did not cite a single health or policy expert on the subject. While we appreciate the perspective of an e-cigarette user, “Higa … doesn’t believe raising vape prices will necessarily stop people from vaping either,” there are many individuals and organizations in Hawaii with far more expertise on these policies and their effectiveness than a 30-year-old sitting outside a coffee shop.

It is surprising that local tobacco and electronic vaping device experts were not consulted. It is especially disappointing because Hawaii is a national leader in tobacco control and prevention, with of adult tobacco smoking.

Hawaii has led national policy efforts to curb smoking rates among children and adults. For example, it was the first state in the nation to raise the legal age of ; this legislation included electronic nicotine devices. The success of Hawaii helped spur similar policies across the nation.

Unfortunately, Hawaii’s successful tobacco control policies have also caught the attention of the tobacco/electronic nicotine device industry. The electronic nicotine device industry to Big Tobacco. For example, in 2018, Altria, the leading United States cigarette manufacturer and parent company of Philip Morris, . While overall the electronic nicotine device industry is less monopolistic than Big Tobacco, they still mimic many of their strategies in order to successfully navigate consumer health complaints.

One of these tactics has been to use front groups and “credible” allies in support of the electronic nicotine device industry, and on products. A frequent tactic has been to argue the merits of electronic nicotine devices for harm reduction, in part to characterize themselves

The arguments made by R Street Institute, a Washington, D.C., based think tank, are classic examples of such tactics. R Street lobbies of taxation touting the harm reduction benefits of electronic nicotine devices. It also reportedly receives .

It is concerning that questions about why a Washington, D.C., think tank would be interested in the local politics of Hawaii were not asked. Most experts in Hawaii are aware of the tactics used by the tobacco/electronic nicotine device industry and could have alerted the journalist to concerns about R Street.

The Civil Beat article focused on adult users of electronic nicotine devices and presented evidence from a context entirely different to Hawaii’s. For example, the only scientific evidence cited in the article came from published in England in 2015.

At that time, the authors of the English report estimated that only 2% of youths in their country were using electronic nicotine devices once or more per month. Comparatively, the most recent numbers available in Hawaii estimate that and use electronic nicotine devices at that same frequency. The Hawaii estimate for current .

The largest percentage of the population using electronic nicotine devices in Hawaii are youth, not adults. Policy proposals to the Hawaii Legislature largely seek to curb access to and use of electronic nicotine devices among young people.

While much more research is needed, there indicating that higher e-cigarette prices will lead to less use among U.S. middle-school and high-school students, because youth are more sensitive to price changes than adults. This is logical, as most young people have less money than adults.

The explosion of electronic nicotine device use among youth is relatively recent and scientific research on effective policies for this age group is still evolving. However, we can draw inferences from successful policies to control tobacco products. High-quality show that tobacco price increases are the most effective intervention to reduce the consumption of tobacco products among price-sensitive youth.

Nicotine is highly addictive and , which continues into the early to mid-20s. In youth, it helps prime the brain for addiction. Electronic nicotine device usage in schools is especially concerning. Hawaii teachers to the legislature that usage of these devices negatively affects student attendance and performance.

These devices negatively affect the ability to concentrate, because nicotine use in adolescence can that control attention, learning, mood, and impulse control. In sum, when initiated at young ages, there are significant concerns about the effects of electronic nicotine devices on lifetime learning and health across the lifespan.

We urgently need courageous lawmakers to contribute to efforts by health professionals and teachers to curb the use of electronic nicotine devices in youth. It is time that we understand electronic nicotine device usage is a public health and educational crisis among our youth.

Hawaii has made enormous progress on tobacco control and has been a leader on tobacco prevention policies, however we have failed to regulate e-cigarettes. After nine years of working on this, it is time for our lawmakers to pass e-cigarette policies to protect our keiki from a lifetime of addiction.

Peggy Mierzwa contributed to this Community Voice.