INDIANAPOLIS (AP) - Indiana needs state taxes to discourage the use of electronic cigarettes as vaping becomes more popular and is increasingly blamed in illnesses and deaths, the state’s main physicians organization and other health advocates said Tuesday.

A vaping tax proposal failed in this year’s legislative session following questions about the tax level and how to charge it but concerns have since grown about vaping among teenagers and a lung ailment linked to e-cigarettes that’s blamed for three deaths in Indiana and at least 26 nationally.

Indiana State Medical Association President Lisa Hatcher, a family physician from Columbia City, told a state legislative committee that many teenagers think they are “using candy” when they use flavored vaping liquids that often contain high levels of nicotine.

More than a dozen states are already taxing vaping liquids, and Hatcher urged Indiana lawmakers to do the same.

“We need to get on that bandwagon and we need to do this urgently,” she said.

At least 1,300 people suffering from vaping-related diseases, including 75 cases in Indiana, have been reported across the country, according to the Centers for Disease Control and Prevention. Doctors say the illnesses, which first appeared in March, have symptoms such as severe shortness of breath, fatigue, and chest pain. Most who got sick said they vaped products containing THC, the marijuana ingredient that causes a high, but some said they vaped only nicotine.

Some Indiana vape shop owners maintain a “punitive” tax would only push adults away from a product that can help them stop smoking cigarettes.

“The legitimate vaping industry should not be targeted because of irresponsible actors and black-market products,” said Shadi Khoury, the owner of Indy E Cigs, a 10-store chain with locations in Indianapolis, Bloomington and Terre Haute.

Indiana legislators this year considered imposing a 20% tax on vaping liquids, aiming to reach a tax level similar to the state’s 99.5 cents per-pack cigarette tax. Another proposal would have set a 4 cents per-milliliter vaping liquid tax. Both proposals were estimated to bring in at least $2 million a year in tax revenue.

Such taxes vary widely across the country, such as Minnesota charging a 95% tax, Illinois a 15% tax and Wisconsin a 5 cents per-milliliter tax, according to the Washington-based Tax Foundation.

Nick Torres, the American Lung Association of Indiana’s advocacy director, argued teenagers are particularly sensitive to price increases and that a tax on vaping liquids should at least match what is charged on cigarettes.

“We would really urge that this is not an arbitrary amount, that this is a significant amount, that it has a bite on the end user, particularly among youth,” Torres said.

Health advocates say teenagers who vape are more likely to become cigarette smokers. That worries them as Indiana’s 21.8% smoking rate among adults was the 7th highest in the country for 2017, according to the CDC. Surveys for the Indiana State Department of Health found 18.5% of high school students had vaped in the past month in 2018, up from 10.5% in 2016.

The legislative committee could vote Friday on whether to recommend adopting a vaping tax, but it would need to win approval from the Republican-dominated Legislature during the 2020 session that begins in early January.

Senate health committee Chairman Ed Charbonneau, who sponsored the vaping tax bill last session, said he didn’t know whether the prominent health concerns about vaping improve the likelihood of a tax being approved. Charbonneau said he was concerned about widespread vaping among teenagers and was considering legislation to limit vaping flavors, which Michigan officials have attempted to ban.

“It raises the question: are the flavored vaping materials directed at helping people stop smoking or creating new vapers?” said Charbonneau, a Republican from Valparaiso. “There are going to be some very strong feelings on both sides of that issue.”

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