Hawaii could raise the legal smoking age to 100, effectively banning cigarettes for the vast majority of people in the state.
In a new bill, proposed by Democrat Richard Creagan, the smoking age would increase rapidly between 2020 and 2024.
It will need to pass through the state legislature and weather a potentially strong backlash from tobacco companies in order to become state law.
E-cigarettes, chewing tobacco and cigars are not included in the bill.
Dr Creagan, who was an emergency room physician before he was elected as state representative in 2014, calls the cigarette "the deadliest artefact in human history" in the bill.
In January 2017, Hawaii became the first US state to raise its smoking age to 21. In other US states the legal age is usually 18 or 19.
The new bill, HB 1509, suggests that the smoking age should go up to 30 in 2020, 40 in 2021, 50 in 2022, and 60 in 2023 - until finally, in 2024, people would need to be 100 years old to buy cigarettes.
