At Hāmākua-Kohala Health, I work with people every day who are trying to quit nicotine. Some are teenagers who never stood a chance, hooked before they hit puberty. Others are adults who have tried to quit more times than they can count, exhausted by a lifetime of addiction.

But I’ve also seen what works: programs that meet people where they are, treat addiction with compassion, and help people quit for good.

I’ve worked one-on-one with a sixth grader in Waimea who started vaping in the third grade. She began with a flavored vape and over the next three years cycled through a variety of flavors, including mint and menthol.

By the time she got to middle school, she was showing signs of full-blown nicotine addiction. It wasn’t until she got into supportive counseling, both individual and group, that she finally started to turn a corner.

Today, she’s a thriving, vape-free seventh grader. But this isn’t a one-off. This is happening right now to kids all over Hawai‘i.

Some have suggested youth vaping isn’t a pressing issue anymore, that they don’t see it as much, so the urgency has passed. But ask any school counselor, health provider, or youth worker. The problem hasn’t gone away. It has just gone underground. Our kids are still getting hooked, and the devices they use are smaller, stronger, and harder to detect than ever.

According to Hawai‘i’s most recent youth tobacco data, 13.2% of high school students and 10.3% of middle school students currently use e-cigarettes. Even more troubling, use among middle school students has jumped since 2021, rising from 6.7% to 10.3%.

That’s thousands of young people exposed to nicotine, often daily, putting them at risk for long-term addiction, mental health issues, and cardiovascular disease.

Many are drawn in by flavors. These flavored products are engineered to mask the harshness of nicotine and hook users more quickly. These aren’t accidental choices. They’re calculated business strategies from the tobacco industry.

The data also reveals stark health disparities. Among middle schoolers, 24.9% of Other Pacific Islanders and 15.5% of Native Hawaiian students report current e-cigarette use, compared to 10.3% overall. At the high school level, 26.7% of Other Pacific Islander youth report current use, double the state average.

These numbers aren’t just statistics. They reflect a long history of aggressive industry tactics aimed at our communities. As a result, Native Hawaiians, Pacific Islanders, and other historically marginalized groups now face significantly higher rates of lung cancer, heart disease, and other tobacco-related illnesses.

Helping People Quit

But we’ve also made progress. In Hawai‘i, community-based programs like ours have helped people quit nicotine or avoid starting in the first place.

Our state’s tobacco prevention and cessation programs have been a public health success. We’ve seen how culturally responsive care, peer counseling, and access to tools like nicotine replacement therapy can change lives.

Unfortunately, federal funding for these programs is at risk, and Hawai‘i could soon be forced to scale back these services. At the same time, the tobacco industry is flooding the market with new products, like nicotine pouches that you stick under your lip, and targeting younger and younger users.

Now is not the time to pull back. It is the time to double down. To protect our keiki, reduce preventable disease, and close health disparities, we need to:

• protect funding for tobacco prevention and cessation programs across Hawai’i;
• strengthen state policies to end the sale of all flavored tobacco and nicotine products, including mint and menthol; and
• support health providers and educators working on the front lines of this crisis.

We have the tools. We know what works. But without bold action and sustained investment, we risk undoing years of progress and putting another generation at risk.

The sixth grader I worked with didn’t quit on her own. She quit because someone believed in her, because she had access to services, and because Hawai‘i still cares enough to fund programs that meet kids like her with open arms and real solutions.

Let’s not let those programs go up in smoke.