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Disparities by income, age persist in tobacco use among Ohio adults

Feb 20, 2020


The Ohio Health Issues Poll is conducted every year to learn more about the health opinions, behaviors and status of Ohio adults. In 2019, OHIP asked Ohio adults several questions about tobacco use and their opinion on tobacco policies.


Ohio adults with lower incomes more likely to be current smokers

More than 2 in 10 Ohio adults (24%) reported being current smokers. This has remained relatively stable since OHIP began asking about smoking status in 2006. However, Ohio adults have consistently been more likely to smoke than adults across the nation. In 2018, the most recent year for which national data are available, 14% of adults nationwide reported being current smokers.1

Responses varied by household income. Ohio adults whose household income was 200% of the Federal Poverty Guidelines2 or less (42%) were nearly three times more likely to report being current smokers than those with household incomes greater than 200% FPG (15%). Since 2006, the percentage of current smokers has declined among Ohio adults with higher income but not among those living in or just above poverty.

Younger adults more likely to have tried e-cigarettes

Electronic cigarettes or e-cigarettes are also known as vapes, vape pens or e-hookahs and many are known by their brand names.3 The majority of e-cigarettes contain nicotine and are not safe for children, young adults, pregnant women or anyone who is not a current smoker.4

Ohio adults ages 18 to 45 (44%) are about twice as likely as older adults (17%) to have ever tried an e-cigarette. This trend has continued since OHIP began asking about e-cigarette use in 2015. (See graph)

About 1 in 10 Ohio adults (11%) reported using e-cigarettes some days, every day or rarely. The Behavioral Risk Factor Surveillance System asks a similar question and found that 5% of adults in the nation used e-cigarettes some days or every day in 2017, the most recent year for which data are available.5 While these questions are similar, it is important to recognize that OHIP allowed the response "rarely" in addition to "œevery day" and "œsome days." Therefore it is not possible to make a direct comparison between the state and national percentages.

Ohio adults' opinions about tobacco policies

OHIP asked Ohio adults whether they favored or opposed other policies that affect tobacco use:

  • An excise tax on the sale of e-cigarettes: 67% favor, 28% oppose. Support has increased since 2018 when 56% favored a tax.
  • A law that raises the age of sale from 18 to 21 on all tobacco products including e-cigarettes: 53% favor, 43% oppose. (See What's Happening Now below.)
  • A $1 per pack increase in the cost of cigarettes: 43% favor, 54% oppose.

Why we ask these questions

Tobacco use is the leading cause of preventable death in the United States. It is responsible for about 20% of all deaths annually.6 Although cigarette use has declined in recent decades, the percentage of adults in Ohio who are current cigarette smokers continues to be higher than the nation. In addition, some people have not experienced this decline in smoking. These include adults living in or just above poverty. These smokers experience more tobacco-related health issues and often lack access to health care that could help treat these issues.7

Assessing public opinion about policies that reduce access to tobacco products is key to understanding the tobacco landscape. E-cigarettes are a newer product that have garnered much media attention in recent months. OHIP aims to understand who is using the products while monitoring the policy landscape across the state.

What's Happening Now

In October 2019, Ohio's Tobacco 21 law went into effect, making it illegal to give, sell or distribute all tobacco products — including e-cigarettes — to anyone under the age of 21. As of January 2020, Ohio is one of 19 states with such a law, along with more than 500 cities and municipalities.8 However, Ohio's law does not include enforcement strategies. Many local jurisdictions, including Cincinnati, are implementing effective enforcement strategies such as compliance checks with retailers and tobacco retailer licensing programs. For more information about the Tobacco 21 legislation visit

1. Centers for Disease Control and Prevention. (2019). BRFSS Prevalence & Trends Data — Current Smoker Status. Retrieved from
2. In 2018, 200% of the Federal Poverty Guidelines for a family of four was $50,200.
3. Centers for Disease Control and Prevention. (2020). About Electronic Cigarettes (E-Cigarettes). Retrieved from
4. Centers for Disease Control and Prevention. (n.d.). Electronic Cigarettes: What's the Bottom Line? Retrieved from
5.  Centers for Disease Control and Prevention. (2019). BRFSS Prevalence & Trends Data — E-Cigarette Use. Retrieved from
6. Centers for Disease Control and Prevention. (2019). Smoking and Tobacco Use. Retrieved from
7. Campaign for Tobacco-Free Kids. (2015). Tobacco and Socioeconomic Status. Retrieved from
8. Tobacco 21. (2019). State by State. Retrieved from

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