A total of 136 stores across Hawai'i have been cited since September for selling tobacco to underage youths.

That amounts to a 13 percent violation rate among the 1,028 stores visited during the sting, the state Health Department said.

Alice Silbanuz, public and professional education coordinator for the department, said that is similar to the rate in previous years, around 12 percent.

Lt. Gov. James "Duke" Aiona said Hawai'i's violation rate is higher than the national average.

He urged retailers to comply with the law and keep youngsters from picking up what he calls "a deadly habit."

O'ahu had the highest violation rate at 14 percent. Kaua'i had the lowest at 9 percent.

DOH conducted the tobacco enforcement operation with volunteers. A group of minors would go undercover with police to buy tobacco from vendors. If the vendors sold the tobacco to the underage volunteers, police would cite the vendors.

The fine for selling tobacco to minors is $500 for the first offense and up to $2,000 for subsequent offenses.

Aside from citations, DOH also works to deter tobacco sales to minors through merchant education, tobacco compliance checks (which extend to lunchwagons) and community interventions.

Silbanuz said store clerks are "our front-line defense for upholding the law that prevents youth under the age of 18 from purchasing tobacco products."

DOH ranks disease prevention as one of its top priorities, and the tobacco enforcement program is part of that. "We believe in taking a proactive approach to prevent disease, rather than wait until our citizens have diminished state of health and have to treat illness," Silbanuz said in an e-mail.

The fewer people who start smoking, the fewer will get sick and incur the high healthcare costs associated with the habit.

Silbanuz said $117 million of the state's Medicaid dollars are spent on healthcare costs directly caused by smoking.

"By decreasing youth smoking and tobacco use, our state will save taxpayers money," she said.