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The Ohio Department of Health (ODH) has issued a health alert to healthcare providers asking them to report all suspected cases of serious pulmonary illness where the cause is unclear with a history of vaping to local or state public health officials for investigation. This is in response to the fact that State and local public health officials are investigating reports of six Ohioans who experienced severe pulmonary illness following use of e-cigarettes, or vaping. The reports follow a recent national alert to healthcare providers by the U.S. Centers for Disease Control and Prevention (CDC) about pulmonary illnesses linked to vaping in at least 16 states, primarily among adolescents and young adults.

CLICK HERE to read the full ODH News Release.

The Centers for Disease Control and Prevention (CDC) has also released a media statement regarding their investigation of at least 193 potential cases of severe lung illness associated with e-cigarette product use in 22 states.  CLICK HERE to see the CDC Media Statement.

Additional information on Electronic Cigarettes (E-Cigarettes) from the CDC is available by CLICKING HERE.

In response to local concerns, the city of Milwaukee has issued a stern warning to residents: Stop vaping immediately. CLICK HERE for details.


Locally, tobacco use contributes to many of Ohio and Cuyahoga County’s greatest health challenges, including cardiovascular disease, cancer, and infant mortality. The number one cause of infant death in Cuyahoga County is prematurity – a major risk factor is maternal tobacco use during pregnancy. Despite state laws prohibiting the sale of tobacco products to minors, access by minors to tobacco and nicotine delivery products continues to be a major public health problem.

With this in mind, a growing number of communities around the country, throughout Ohio and here in Cuyahoga County have chosen to move forward with local ordinances prohibiting the sale of tobacco, tobacco-related products and alternative delivery devices to anyone under the age of 21. To date, the following communities have either adopted or are in the process of adopting local regulations: Brooklyn, Cleveland, Cleveland Heights, Euclid, Lakewood, Moreland Hills, Newburgh Heights and University Heights.

We fully support these communities and their efforts to research, draft, discuss and implement these local ordinances and update existing codes to prohibit the sale of tobacco and related products to anyone under the age of 21.  These ordinances are not meant to criminalize 18 – 20 year olds for smoking or buying tobacco products.  The focus and responsibility of meeting the requirements within the code is placed squarely on the retailer (business owner) that allows the sale of tobacco products to underage buyers.



Our staff partners with each community to educate residents and local business owners on the implementation of the Tobacco 21 program and continues to work closely with these business owners throughout the permitting process. Ordinances passed by the communities require each business that sells or distributes tobacco or tobacco related products to the public to be locally permitted to do so. They are also required to post the appropriate signage at or near the tobacco sales transaction point.

CCBH staff will be conducting routine site inspections to ensure that these requirements are being met. We will also continue to respond to any complaints filed regarding the sale of tobacco products to underage buyers. Periodic random unannounced compliance checks will also be conducted, which will include a CCBH controlled attempted purchase of tobacco products by an underage customer. Violations will result in a tiered enforcement process, which includes written warnings, monetary fines and ultimately the potential revocation of the seller’s permit.


Smoking harms nearly every organ of the body, causing many diseases and affecting the health of smokers in general. Quitting smoking has immediate as well as long-term benefits for you and your loved ones. Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Nearly 40 million US adults still smoke cigarettes, and about 4.7 million middle and high school students use at least one tobacco product, including e-cigarettes. Every day, more than 3,800 youth younger than 18 years smoke their first cigarette. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. Another 16 million live with a serious illness caused by smoking. Each year, the United States spends nearly $170 billion on medical care to treat smoking-related disease in adults. Youth use of tobacco products in any form is unsafe, irrespective of whether it is smoked, smokeless, or electronic. If cigarette smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans younger than 18 will die early from a smoking-related illness. That’s about 1 of every 13 Americans aged 17 years or younger alive today.

Research provided by a coalition of the Cancer Action Network of the American Cancer Society, the American Lung Association, the American Heart Association, and the Campaign for Tobacco-Free Kids indicates that 95% of all adult smokers begin smoking before they turn 21 years old, and that adolescence is a critical period when many smokers move from experimental smoking to regular, daily use. Early exposure to nicotine increases the risk of addiction and puts adolescents at a higher risk for depression, anxiety and substance abuse. The primary source of tobacco products for underage smokers are their 18 to 20 year old peers, since 80% of high school students turn 18 before they graduate.

For assistance in starting a Tobacco 21 program or to learn more about what we do, please call our Environmental Public Health staff at 216.201.2000 between 8:30 a.m. and 4:30 p.m.


2019 CCBH Retail Tobacco Sales Permit Application

CCBH Tobacco 21 Program Implementation Process Map

CDC – Smoking & Tobacco Use

Ohio Department of Health Smoking Prevention & Cessation

Ohio Raises Legal Smoking Age to 21 

Tobacco 21