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of note, the proportion of non-smokers who started using electronic smoking devices was rather low.7 Recent data from the Behavioural Risk Factor Surveillance System (BRFSS) suggest that the use of electronic cigarettes is increasing among never-smokers, to nearly 2 million US adults in 2016.8 The mean prevalence of never-smokers who smoked electronic cigarettes at least once ranges from 0.1 to 3.8%.7,9,10 Those electronic cigarette users who have never smoked conventional cigarettes are defined as sole electronic cigarettearette users in the literature

While our comprehensive approach to addressing tobacco use in Hawaii has led to quantifiable decreases in deaths due to smoking, an increase in targeted marketing to our youth and young adults and new technology in the form of e-cigarettes requires our state to take additional measures to protect our young people. Under the new law, people under 21 caught smoking are subject to a $10 fine the first time and $50 fines for repeat offenses

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And then there is the developing world, where the rate at which governments and public opinion are turning against tobacco differ dramatically from wealthier economies

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