INDIANAPOLIS (AP) — The leader of Indiana’s main physicians organization says the spread of vaping-related illnesses and deaths show the need for state taxes to discourage electronic cigarette use.

Indiana State Medical Association president Dr. Lisa Hatcher of Columbia City told a state legislative committee Tuesday that Indiana needed to join other states with excise taxes on e-cigarette liquids.

A vaping tax proposal failed in this year’s legislative session amid questions about the tax level and how to charge it. Hatcher and other tax supporters argue the tax could especially discourage teenagers from vaping.

Health officials blame three deaths in Indiana and at least 26 nationally on severe lung injuries caused by vaping.

Indiana vape shop owners maintain black-market products are the problem and that they cater only to adult customers.