HONOLULU (Reuters) - Hawaii lawmakers on Friday passed a bill that would raise the legal smoking age statewide to 21, positioning it to become the first state in the country to do so.

The bill, which passed the state Senate by a vote of 19-4 after clearing the house last week, would also ban the sale, purchase or use of electronic cigarettes for those under the age of 21.

"The activities we've engaged in over the years to manage smoking, our additional efforts in education, the raising of cigarette taxes, this is a continuation of those policies," Democratic state Senator Rosalyn Baker, one of the bill's sponsors, told Reuters.

She said opponents of the measure have argued that it limits choice for people considered adults in other situations, like joining the military, but added: "To me, giving someone the choice to have lung cancer is not a good choice."

Governor David Ige will have to approve the measure. Ide spokeswoman Jodi Leong said he would make a decision only after reviewing the bill, which would likely happen next week.

Most U.S. states set the legal smoking age at 18, while a handful have set it higher at 19. Some cities and counties, including New York City and Hawaii County, have already raised the smoking age to 21.

Lawmakers in Washington state and California have also pushed to raise the legal smoking age to 21 in recent months.

The Campaign for Tobacco Free Kids said that tobacco use kills 1,400 people and costs some $526 million in medical bills annually in Hawaii. It added that about 95 percent of adult smokers started before they were 21 years old.

Cigarette smoking is the leading cause of preventable death in the United States, accounting for more than 480,000 deaths annually, or one of every five deaths overall, according to the U.S. Centers for Disease Control and Prevention.

Researchers have found that raising the minimum age to purchase tobacco products to 21 or 25 years old would significantly reduce smoking and tobacco-related illnesses in the country and that a majority of U.S. adults support raising the legal age to 21.

Smoking rates in the country have dropped sharply to 18 percent of the population today down from 42 percent in 1964.

(Writing by Curtis Skinner; Editing by Michael Perry)