Chronic Disease + Tobacco

Local health departments are on the front lines of America's battle against chronic diseases, such as obesity, diabetes and heart disease.  Tobacco use also remains a significant public health issue. 


In the ever-evolving tobacco market, new products, such as e-cigarettes, are being marketed to appeal to youth in particular. Youth use of e-cigarettes tripled between 2013 and 2014, and poisoning involving e-cigarettes and liquid nicotine have increased dramatically. These products threaten to undermine progress made in reducing tobacco use, and the current lack of e-cigarette regulation makes consumers vulnerable to fraud, deception, and unknown health risks. Without government regulators to ensure the integrity of e-cigarette component ingredients and the safety of the e-cigarette devices, the public is left with little more than the producers' assurances that they are not inhaling heavy metals and carcinogens. 

Click here to learn how Seattle banned e-cigarettes.

Click here to learn how Seattle banned e-cigarettes.

While many local health departments have taken steps to curb sales and use of e-cigarettes, not all localities have this regulatory authority and there are additional areas, such as marketing, manufacturing and labeling, where the Food and Drug Administration is responsible for oversight. The coalition is working to advocate for federal regulations to be issued by the FDA to address the sale, marketing, manufacturing, and labeling of e-cigarettes.

Tobacco 21

Tobacco 21 is a policy that has been put in place by 135 localities throughout the U.S. to raise the age of tobacco sale from 18 to 21. 95 percent of adult smokers started before they were 21, demonstrating the critical importance of keeping young people from ever starting. A national consensus is growing to prevent addictions and future health problems by supporting Tobacco 21. Three-quarters of Americans favor raising the tobacco age of sale to 21 years, including seven in ten smokers.

Click here to learn how New York City prevents smoking by raising the smoke sale age and price.

Click here to learn how New York City prevents smoking by raising the smoke sale age and price.

A report by the Institute of Medicine (IOM) concluded that raising the tobacco sale age to 21 could significantly reduce the number of adolescents and young adults who start smoking, and over time will reduce adult smoking by about 12 percent. It would also result in 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost for those born between 2000 and 2019. Tobacco 21 will also reduce medical costs. Tobacco use costs the United States approximately $170 billion in direct medical costs and $156 billion in lost productivity every year.

Read more in our August 2014 letter to FDA Commissioner Margaret Hamburg.

Read more in our press release, Big Cities Health Coalition Weighs In On Smoldering E-Cigarettes Debate