Youth use of e-cigarettes, more commonly referred to as vaping, has increased so dramatically over the past several years that the Centers for Disease Control and Prevention now classifies youth vaping as an epidemic. Less than five percent of adults in Hawaiʻi use e-cigarettes, yet 26 percent of Hawai‘i high school students report using these devices. In Maui County, almost 33 percent of our high school students and 18 percent of our middle school students are currently vaping, while over half of youth have tried or experimented with these products.

Native Hawaiian and LGBT youth are impacted at even higher rates (41 percent and 51 percent for high school students, respectively). Elementary schools across Maui County and the state are also reporting student use as early as second, third, or fourth grade.

To gather the community around this issue, the Maui, Molokaʻi, and Lanaʻi Coalition for a Tobacco-Free Hawai’i (CTFH), in partnership with Blue Zones Project Central Maui, held a free public symposium in the Kamehameha Schools Maui Nānāhana Dining Hall. It drew over 100 people, including parents, youth, medical and public health professionals, educators, and lawmakers.

Keynote speaker, Dr. Bonnie Halpern-Felsher, Professor in the Division of Adolescent Medicine, Department of Pediatrics, Stanford University, spoke to the motivations, psychology, and physiology of youth vaping and addiction. “We are born with the ability to become addicted to drugs. When under 25, chances of becoming addicted increase dramatically; these youth are four times more likely to become addicted. They get you for a lifetime,” she said, adding, “There are over 15,000 flavors on the market now for e-cigarettes. We do not need unicorn poop to help people quit smoking. The tobacco industry has a kids menu. We need to get the flavors off the market.”

Kawena Kekuewa, of the Maui Nui Youth Council (MNYC) and the CTFH Youth Council, highlighted the marketing tactics, especially candy flavors, used by the industry to entice and addict youth. “Here in Maui County, 41.7 percent  of our Native Hawaiian high school students and 27.8 percent of our Native Hawaiian middle school students are current users,” she said. “Let that sink in, more than a quarter of our Native Hawaiian middle school students are actively vaping, and over 40 percent of our Native Hawaiian high school students are using these products. Who do you think tobacco companies are trying to catch? It’s very obvious, and it’s infuriating. As a youth, I’m outraged, and you should be too.”

In addition to her presentation on how flavors hook kids, Kawena was awarded the 2019 MNYC State Youth Advocate Award for the work she has done around youth tobacco and alcohol prevention at the state level. Tyler Fisher, also of the MNYC and CTFH Youth Councils, was awarded the 2019 MNYC County Youth Advocate Award for his work in Maui County.

Kevin Ramirez, 808 No Vape Campaign Coordinator, and Trish La Chica, Hawai‘i Public Health Institute Policy and Advocacy Director, reviewed the policy and regulation landscape, around electronic smoking devices nationally, statewide, and locally, while also identifying next steps in tackling this epidemic here at home, including proposed regulations for taxes, permitting and licensing, online sales restrictions, and eliminating the sale of flavored tobacco for the State of Hawai’i. It has been proven that such regulations work to reduce youth use of tobacco. While industry supporters who oppose such regulations argue that e-cigarettes help smokers to quit traditional cigarettes, Jessica Yamauchi, Executive Director of Hawai‘i Public Health Institute, shared a disturbing statistic derived by Oahu pediatrician Dr. Brian Mih, “For every one adult who quits smoking by using e-cigarettes, 81 young people begin tobacco use through e-cigarettes.”

A panel discussion and Q&A concluded the program, featuring Principal Timothy Shim of Kalama Intermediate, Dr. Jeffrey H. Chester, the Director of Akamai Recovery Maui, Dr. Dean Felsher, Professor of Oncology at Stanford University, and Lila Johnson, Hawaiʻi State Department of Health Tobacco Prevention and Education Program Director. School Resource Officer Brandon Phillips provided a resource table to answer questions specific to enforcement. When asked how parents can be allies to the schools in dealing with this issue, Principal Shim of Kalama Intermediate answered, “I’ve seen the vaping issue exponentially increase over the past few years. For the parents…it is a matter of being aware. We need more parents, more educators, more leaders in the community telling lawmakers that they don’t want their children being the next headline.”