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Nevertheless, the survey shows that the prevalence of ever smokers among Secondary 1 to 6 students was 7.4% in 2021, reflecting that there are still a significant number of students who would experiment with smoking out of curiosity, while minors still have access to tobacco products under the prevailing regulations.[19] Given the very low prevalence in the 15-19 years group, and a prevalence of only 2.6% in persons below the age of 25, raising the legal age for purchasing tobacco products to 21 or above will unlikely have significant impact on reducing smoking prevalence and preventing young people from smoking

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Establishments are required to post signs stating that sales to minors are prohibited.6,7 Minors are prohibited from buying electronic smoking devices, including e-cigarettes.6 Distribution of samples of electronic smoking devices on public property or within 1000 feet of a school is prohibited.9 Delivery sales of electronic smoking devices require third-party verification, copy of government issued identification or age and signature verification in shipment process upon and before actual delivery.9 Local tobacco laws Use of electronic smoking devices prohibited in state parks, on indoor and outdoor areas if Hawaii Health Systems Corporation Property and in enclosed or partially enclosed places that are owned, leased, or operated by the state or counties, open to the public, places of employment, sports areas/stadiums, and within 20 feet of entrances and exits to such places.9 It is prohibited to smoke or use tobacco, including using e-cigarettes, on the premises of the University of Hawaii.10 Quitting statistics and benefits Quitting smoking in Hawaii The CDC estimates 42.8% of daily adult smokers in Hawaii quit smoking for one or more days in 2019.3 In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications