Feb. 15 (UPI) -- Hawaii could eventually become the first state in the nation to ban cigarettes entirely -- an idea bolstered this year by a plan to raise the legal smoking age to 100.
Democratic state Rep. Richard Creagan, who is also a doctor, has sponsored legislation this year with Republican Rep. Cynthia Thielen and fellow Democrat Rep. John M. Mizuno that raises the age in increments -- to age 30 in 2020, 40 in 2021, 50 in 2022 and, finally, 100 in 2024.
The bill exempts electronic cigarettes, cigars, smokeless tobacco and other alternatives. After it was introduced Jan. 24, the Hawaii House voted to put it on hold, for now.
"The cigarette is considered the deadliest artifact in human history. The cigarette is an unreasonably dangerous and defective product, killing half of its long-term users," the bill states.
Nationally, cigarette use is on the decline -- dropping to 14 percent of adults 18 or older between 2005 and 2017, according to the Centers for Disease Control and Prevention.
However, Creagan still believes the proposed smoking ban is necessary to save lives. He told UPI he expected some pushback, but he and its co-sponsors are committed to pushing it into Hawaii law. An alternative might be to raise the smoking age to 25 from the current 21.
Getting tough on tobacco
While cigarette smoking is in decline, the American Heart Association's "State of Tobacco Control" report this year found many federal and local governments have failed to curb tobacco use.
The AHA cited failures in many states -- to strengthen smoke-free workplace laws, increase tobacco taxes, help smokers quit and raise the legal age. The CDC recommends states "establish control programs" that are comprehensive, sustainable and accountable -- and include components like community interventions, public education, cessation programs, surveillance and evaluation and administration and management.
Hawaii has been at the forefront of the fight against smoking for years. In 2016, it became the first state to raise the legal age to 21.
The law also expanded indoor air ordinances in all government and private workplaces, schools, childcare facilities, restaurants, bars, retail stores and cultural facilities to ban the use of e-cigarettes.
Other states -- California, New Jersey, Massachusetts, Oregon and Maine -- and more than 350 cities and towns -- including New York City and Washington, D.C. -- followed suit and raised their legal age.
Additionally, Hawaii's taxes on cigarettes are the fifth-highest in the nation, at $3.20 per pack. The state also taxes little cigars 15 cents apiece, large cigars at 50 percent of their wholesale price and all other tobacco products at 70 percent. The state spent $6.6 million on tobacco prevention in fiscal 2018, nearly 50 percent of the CDC's recommended spending total of $13.7 million, according to Tobacco Free Kids.
The AHA recommended Hawaii increase tobacco taxes by $1 per pack or more, maintain funding for tobacco prevention and cessation programs and repeal pre-emption of local tobacco sales laws, to improve its tobacco policies.
'A terrible addiction'
Creagan told UPI he was inspired to sponsor the bill after tobacco experts declared the number of cigarette users in the country was dwindling, but there was no clear plan for getting the rest to quit.
"This seemed to be a good endgame, that over five years you could basically phase out the sale of cigarettes," he said.
He said the focus of the bill is penalizing stores for selling cigarettes and fining retailers, instead of smokers, to protect what he called victims of the addictive products.
"We're not even saying it's illegal to smoke, you just can't sell cigarettes," Creagan said. "The people attempting to buy them are victims of a terrible addiction and I don't see why we should be punishing, essentially ill people because they're addicted."
Raising the legal smoking age could also help save those who began smoking in their youth, he said.
"Say you started smoking when you were a teenager; if you stop smoking at 30, your life expectancy is essentially the same as if you never smoked. And at 40, it's one year less than if you never smoked," Creagan said. "So if you stop smoking at those points, people will live almost a normal life."
CDC statistics show cigarettes are the leading cause of preventable deaths in the United States, responsible for more than 480,000 a year. The agency also noted that smoking has been linked to 90 percent of lung cancer deaths and 80 percent of all deaths from chronic obstructive pulmonary disease.
Although Creagan supports raising the age to 25, he'd prefer it be 30 -- to most effectively prevent complications in pregnancy. Difficulty conceiving, early delivery, stillbirth, sudden infant death syndrome, ectopic pregnancy, orofacial clefts in infants and low birth weight are all side effects linked to cigarettes.
"A lot of the effects of smoking are long term, but some of the effects are very short term or immediate, and those are the effects on pregnant women and fetuses. So a ban for 30 and under and even 25 and under would help protect a lot of those women and their fetuses."
Additionally, the lawmaker hopes his efforts can prevent young people who've taken to "vaping" from switching to cigarettes.
"People who are vaping now, who might go to cigarette smoking, it would be harder for them to do that," he said. "In my view, vaping is not carcinogenic, it doesn't cause cancer, it has just nicotine and nicotine by itself is relatively innocuous."
Although the proposed bill would allow tourists to bring cigarettes to the islands, and smoke in designated areas, Creagan believes stronger laws will also make the state a more desirable destination.
"We're a tourist state and I think tourists would enjoy coming to a place where they couldn't buy cigarettes," he said.
Finding sustainable solutions
One of the major barriers to implementing a tobacco ban is the revenue Hawaii receives from cigarette taxes, Creagan said. Last year, it received $168.3 million from the taxes.
"The legislature here just did not want that source of money impinged," he said. "It appears they'd rather have people continue to smoke and die because they need their money. I don't think that's very morally right or ethical."
That's why the proposed cigarette ban would be implemented in phases -- to soften the loss of revenue. It's a key issue some in the tobacco industry say may be too significant to overcome.
"Don't you think legislators who make such proposals should level with their constituents and voters to explain the ramifications? I think people should start asking these questions and posing these questions to elected officials," ITG Brands spokesman Mark Smith told UPI. North Carolina-based ITG is the third-largest U.S. tobacco distributor and makes popular brands like Winston and Kool.
While the proposed bill was ambitious, Stanton Glantz, a professor at the University of California San Francisco's Center for Tobacco Control Research and education, told UPI it may not be the most effective method. He contends that strong laws to limit -- not ban -- cigarette use might make a quicker impact.
"The evidence shows that if you run an effective tobacco control program, you can drive smoking down pretty quickly," he said, adding that he recommends strengthening indoor air laws and higher taxes.
"Here in San Francisco, we passed a law that prohibited the sale of all flavored tobacco products and I think that's a very important thing to do."
In the meantime, Creagan said he will keep trying to persuade Hawaii lawmakers to take the next step in making the islands virtually smoke-free.
"You could put some of these conditions, probably the 25 age limit, into a bill that comes here from the Senate and we'll probably try that," he said. "If that doesn't happen, we'll come back next year. In the meantime, we'll try to educate our fellow legislators about the reason we're doing this."