If ongoing state and national investigations provide conclusive evidence that vaping is behind a recent trend of lung illness, the Hawaii Department of Health is prepared to pull certain e-cigarette products from the shelves, officials said.

The health department Monday stopped short of placing an outright ban on e-cigarette products and paraphernalia, instead issuing a public health advisory “urging everyone to stop vaping, no matter the substance or source,” until national investigations are complete.

The warning came as the department announced that a second person in Hawaii has fallen ill from health issues related to vaping. Hawaii’s first case, involving a minor on the Big Island, was reported last month.

Bruce Anderson, the Hawaii state director of health, said he has the authority to ban the sale of e-cigarette products if evidence points to a specific product that causes harm to public health.

“We actually considered that but we don’t have enough evidence to take that step yet,” he told Civil Beat. “If we find a specific product that is associated with these cases, we will ban or embargo that product. So far we haven’t found any specific products that seem to be causing that illness so we are still investigating.”

Hawaii’s first reported case of a potentially vaping-related lung illness surfaced last month. It affected a Big Island minor and followed a string of more than a thousand lung illness cases throughout the country. Anderson said Monday that the minor who was hospitalized has since recovered.

“As far as I know the individual has recovered, fortunately; that’s the good news,” Anderson said. “The illness was obviously associated with vaping but no particular product was identified. We need to find out more about the history of the case.”

The second case of a vaping-related lung illness has affected an adult, but the department did not reveal the patient’s age or any more details.

At least 18 people have died in the U.S. because of conditions associated with vaping and e-cigarettes, according to the department.

Hawaii has some of the highest rates of vaping in the nation, with approximately one-quarter of all Hawaii high school youth currently smoking e-cigarettes.  Students as young as second and third graders have been caught vaping, according to Lola Irvin, the administrator of the state Chronic Disease Prevention and Health Promotion Division.

In Hawaii, businesses are required to have a general excise license to sell vaping products.

The state governments of New York, Massachusetts, Washington and Oregon have used executive orders to temporarily ban the sale of e-cigarette products.

When asked if he would consider a similar executive order, Gov. David Ige said the state is focusing on finding “specific products that are dangerous or harming us.”

“Hawaii has not yet seen as many cases that have arisen on the mainland,” he said.

Volcano e-Cigs, a Hawaii-based company, issued a press release Monday critical of the state’s actions, saying that nationally most of the illnesses related to vaping occurred with the use of illicitly-bought products containing THC. They also cited studies showing vaping was much safer than smoking cigarettes.

“Identifying the true cause of these illnesses and reporting them accurately so that the public can make informed decisions should take precedence over fear mongering,” Volcano owner Cory Smith said in the release.