TOBACCO 21
Program Contacts
Every day, more than 3,800 youth younger than 18 years old smoke their first cigarette. Youth use of tobacco products in any form is unsafe, irrespective of whether it is smoked, smokeless, or electronic. If smoking continues at current rates, 5.6 million—or 1 out of every 13—of today’s children will ultimately die prematurely from a smoking-related illness.
Although E-cigarettes have been the most commonly used tobacco product among youth since 2014, other tobacco products used by middle and high school students include cigars, cigarettes, smokeless tobacco, hookahs, and pipe tobacco.
In 2023, more than 6 of every 100 middle school students (6.6%) and about 1 of every 8 high school students (12.6%) reported current use of a tobacco product. Likewise, nearly 15 of every 100 middle school students (14.7%) and nearly 28 of every 100 high school students (27.9%) said they had ever tried a tobacco product.
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.
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.
Why we support Tobacco 21
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 and a major risk factor is maternal tobacco use during pregnancy.
Despite state laws prohibiting the sale of tobacco products to those under 21, minors having access to tobacco and nicotine delivery products continues to be a major public health problem.
A growing number of communities throughout Ohio and here in Cuyahoga County have chosen to move forward with local ordinances that support legislative changes at the state level prohibiting the sale of tobacco, tobacco-related products and alternative delivery devices to anyone under the age of 21.
To date, the following communities in Cuyahoga County have adopted local Tobacco 21 (T21) regulations:
We fully support these communities and their efforts to 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 role in local Tobacco 21 programs
CCBH staff partners with each community to educate residents and local business owners about the Tobacco 21 program. We continue 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. They are also required to post the appropriate signage at or near the tobacco sales transaction point.
CCBH staff conduct routine site inspections to ensure that these requirements are being met. We also continue to respond to any complaints filed regarding the sale of tobacco products to underage buyers.
Periodic random unannounced compliance checks are also conducted, which include a CCBH-controlled attempted purchase of tobacco products by an underage customer.
Violations result in a tiered enforcement process, which includes written warnings, monetary civil penalties and ultimately the potential revocation of the seller’s permit.
The impact of tobacco
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.
Each year, nearly 500,000 Americans die prematurely of smoking or exposure to secondhand smoke. Another 16 million live with a serious illness caused by smoking.
Tobacco use is the leading cause of preventable disease, disability, and death in the United States.
The United States spends nearly $170 billion annually on medical care to treat smoking-related disease in adults.
Contact Us
For assistance in starting a Tobacco 21 program or to learn more about what we do, call 216.201.2000 between 8:30 a.m-4:30 p.m.
Resources & Links
2024 CCBH Retail Tobacco Sales Permit Application
CCBH Tobacco 21 Program Implementation Process Map
Centers for Disease Control and Prevention – Smoking & Tobacco Use
Infant Mortality – CCBH webpage
Ohio Department of Health Smoking Prevention & Cessation
Ohio Raises Legal Smoking Age to 21
For the latest information about vaping, please click here.