Tobacco is the leading cause of preventable death in the United States. Our nation spends billions every year to treat tobacco-related diseases. District Health Department No. 2 recognizes this problem and endeavors to reduce tobacco’s impact in the district. The District employs a comprehensive tobacco and secondhand smoke prevention program that includes a combination of environmental and policy change techniques as well as community education to reduce tobacco’s burden on the area.

What We Do:

  • Serve as a referral source and clearinghouse for the community regarding tobacco use issues.
  • Provide information on programs and services such as smoking cessation, and quit tips and assist with insurance questions.
  • Provide tobacco education through presentations, displays, and meetings.
  • Serve as a data source for information regarding smoking statistics, smoke-free legislative information, and smoke-free rental housing options.
  • Provide current information regarding laws, policies, and tobacco education campaigns at the national, state, and local levels to groups and individuals.

Tobacco Control Act 

To protect the public and create a healthier future for all Americans, the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act), signed into law on June 22, 2009, gives FDA authority to regulate the manufacture, distribution, and marketing of tobacco products.

The Tobacco Control Act puts in place specific restrictions on marketing tobacco products to children and gives FDA authority to take further action in the future to protect public health. These provisions ban:

  • sales to minors
  • vending machine sales*
  • the sale of packages of fewer than 20 cigarettes
  • tobacco-brand sponsorships of sports and entertainment events or other social or cultural events
  • free giveaways of sample cigarettes and brand-name non-tobacco promotional items

* except in adult-only facilities 


Tobacco Control Legislation

Report a Potential Tobacco Product Violation

Michigan’s Smoke-Free Indoor Air Law

Effective May 1, 2010: All public businesses, including restaurants, bars and hotels/motels/inns are required to be smoke-free. The only exceptions are tobacco specialty shops, designated cigar bars and the gaming floors of casinos.

The Smoke-Free Air Law helps to protect children and non-smoking citizens from the dangers of second-hand smoke. It also allows for healthier work environments for employees. Tobacco smoke contains toxins and carcinogens which are responsible for disease and death among innocent bystanders.

For more information, including Frequently Asked Questions and Answers, please see the links on the right.

To report a violation of the Smoke-Free Law, please call our Tobacco Coordinator at (989) 343-1852. Complaints will be accepted for establishments located in Alcona, Iosco, Ogemaw and Oscoda counties.


MI Smoke-Free  Air Law

MI Smoke-Free Air Law FAQs

Tobacco 21

On Dec. 20, 2019, the President signed legislation amending the Federal Food, Drug, and Cosmetic Act, and raising the federal minimum age for sale of tobacco products from 18 to 21 years. This legislation (known as “Tobacco 21” or “T21”) became effective immediately, and it is now illegal for a retailer to sell any tobacco product—including cigarettes, cigars, and e-cigarettes—to anyone under 21. The new federal minimum age of sale applies to all retail establishments and persons with no exceptions.

District Health Department No. 2 partners with Northern Michigan Regional Entity to conduct tobacco compliance checks at tobacco retailers across the district.  Staff also work with local law enforcement and state law enforcement officials to assist.  The goal of the program is to ensure compliance with the Michigan Youth Tobacco Act and ensure retailers are not selling tobacco to minors.


Youth Tobacco Prevention (CDC)

Tobacco 21 Legislation

Tobacco Retailers

Tobacco retailers are responsible for complying with the Michigan Youth Tobacco Act in preventing underage tobacco use. This law requires tobacco retailers to post the Youth Tobacco Act warning sticker near each place of sale. Managers are also responsible for training their employees on properly checking identification. The state of Michigan has developed a Tobacco Retailer Kit to help retailers comply with the law. Penalties for breaking the Youth Tobacco Act may include fines and court costs.

Vendor Education

2022 Retail Education Packet

Read the Red

Tobacco Birthdate Flyer – English

Tobacco Birthdate Flyer – Spanish

Tobacco Birthdate Flyer – Arabic


Tobacco Cessation

Quitting smoking results in the following health benefits:

  • Lower risk for lung cancer and many other types of cancer.
  • Reduced risk for heart disease, stroke, peripheral vascular disease (narrowing blood vessels outside your heart), and lung diseases including Chronic Obstructive Pulmonary Disease (COPD).
  • Less coughing, wheezing, and shortness of breath.
  • Reduced risk for infertility in women of childbearing age. Women who stop smoking during pregnancy also reduce their risk of having a low birth weight baby.
  • Quitting before the age of 40 reduces the risk of dying from smoking-related disease by about 90%

The Michigan Tobacco QuitLine is offered to help Michigan residents quit tobacco use. To contact the QuitLine, call 1-800- QUIT-NOW (1-800- 784-8669). The Quitline is available 24 hours a day, free of charge to anyone. Ongoing counseling and Nicotine Replacement Therapy may be free for those who qualify. Please Note: Pregnant women and Veterans are eligible to enroll in the Michigan Tobacco Quitline regardless of insurance status. For additional help and resources, please see the links below. 

Michigan Tobacco Quitline

MDHHS Smoking Cessation Tools and Resources

My Life, My Quit (Anti-Smoking Teen Website)

Become a Smokefree Veteran 

Tobacco Education Resource Library

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.

Truth Initiative Youth Smoking and Vaping Prevention 

Tobacco Free Kids 

Smokefree Teen


Tobacco and E-Cigarettes

What is Menthol?

 Menthol is a chemical compound found naturally in peppermint and other similar plants. Menthol can also be produced in a lab.

Menthol can change the way the brain registers the sensations of taste and pain. In cigarettes, menthol creates a cooling sensation in the throat and airways, making the smoke feel less harsh and easier to inhale. Menthol is also used in other commercial tobacco products, such as e-cigarettes, cigars, hookah tobacco, smokeless tobacco, nicotine pouches, and heated tobacco products.

According to federal law, tobacco manufacturers cannot market cigarettes with “characterizing flavors,” except for menthol- or tobacco-flavored cigarettes. Almost all the cigarettes sold in the United States contain some natural or lab-created menthol. However, there is usually more menthol in cigarettes marketed specifically as “menthol” compared to other cigarettes. In 2019 and in 2020, sales of menthol-flavored cigarettes made up 37% of all cigarette sales in the U.S.—the highest proportion since major tobacco companies were first required to report those data to the federal government in 1967.

The Bottom Line:

  • Tobacco companies add menthol to commercial tobacco products to make them seem less harsh and more appealing to young people and to people who have never used tobacco products.
  • Nicotine is the addictive drug in cigarettes and other tobacco products. Menthol enhances the effects of nicotine on the brain and can make tobacco products even more addictive. In recent years, tobacco companies also have increased the amount of nicotine in some menthol cigarettes.
  • Menthol in cigarettes can make it more difficult to quit smoking. People who smoke menthol cigarettes can be less likely to successfully quit than people who smoke non-menthol cigarettes.
  • Tobacco companies aggressively market menthol-flavored tobacco products to different groups of people, especially Black people. This marketing contributes to targeted population groups being more likely to smoke menthol cigarettes than other population groups.
  • Young people, racial and ethnic minority groups, LGBTQ+ people, women, people with a low income, and people with mental health conditions also are more likely to smoke menthol cigarettes than other population groups.
  • We can help reduce menthol tobacco use and help people quit using tobacco products by:
    • Increasing equitable access to evidence-based quitting resources, including counseling and medication.
    • Implementing policies that prohibit or decrease sales of menthol tobacco products.

What are E-cigarettes?

  • E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.
  • E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—flavorings, and other chemicals that help to make the aerosol. Users inhale this aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales into the air.
  • E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).”
  • Some e-cigarettes are made to look like regular cigarettes, cigars, or pipes. Some resemble pens, USB sticks, and other everyday items. Larger devices such as tank systems, or “mods,” do not resemble other tobacco products.
  • Using an e-cigarette is sometimes called “vaping.”
  • E-cigarettes can be used to deliver marijuana and other drugs

What is in E-cigarette Aerosol?

The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including:

  • Nicotine
  • Ultrafine particles that can be inhaled deep into the lungs
  • Flavoring such as diacetyl, a chemical linked to a serious lung disease
  • Volatile organic compounds
  • Cancer-causing chemicals
  • Heavy metals such as nickel, tin, and lead1

It is difficult for consumers to know what e-cigarette products contain. For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine.2

Health Effects:

E-cigarettes are still fairly new, and scientists are still learning about their long-term health effects. Here is what we know now.

Most e-cigarettes contain nicotine, which has known health effects.1

  • Nicotine is highly addictive.
  • Nicotine is toxic to developing fetuses.
  • Nicotine can harm adolescent and young adult brain development, which continues into the early to mid-20s.
  • Nicotine is a health danger for pregnant adults and their developing babies.

Besides nicotine, e-cigarette aerosol can contain substances that harm the body.1

  • This includes cancer-causing chemicals and tiny particles that reach deep into lungs. However, e-cigarette aerosol generally contains fewer harmful chemicals than smoke from burned tobacco products.

Smokeless tobacco is chewed, snuffed, or placed between the gum and the cheek or lip. It contains nicotine, which is highly addictive.

Health risks of using smokeless tobacco:

  • Can cause gum disease, tooth decay, and tooth loss
  • White or gray patches inside the mouth (leukoplakia) that can lead to cancer
  • Increased risk for death from heart disease and stroke
  • Nicotine poisoning in children
  • During pregnancy can increase the risk for early delivery and stillbirth

Hookahs are water pipes used to smoke specially made tobacco that comes in different flavors, such as apple, mint, cherry, etc. Hookah smoking has similar health risks to cigarette smoking. 

Health risks of using Hookah:

  • Hookah contains highly addictive nicotine
  • An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs
  • The charcoal used to heat the Hookah tobacco produces high levels of carbon monoxide, metals, and cancer-causing chemicals
  • Infections may be passed between smokers since Hookah mouthpieces are shared in groups
  • Secondhand smoke from hookahs can be a health risk for nonsmokers


Smoke Exposure

What is Secondhand Smoke?

  • Secondhand smoke is smoke from burning tobacco products, like cigarettes, cigars, hookahs, or pipes.
  • Secondhand smoke also is smoke that has been exhaled, or breathed out, by the person smoking.
  • There are more than 7,000 chemicals in tobacco smoke, including hundreds of chemicals that are toxic and about 70 that can cause cancer.

How Secondhand Smoke Harms Children

  • Because their bodies are still growing, infants and young children are especially vulnerable to health risks from secondhand smoke.
  • Babies who breathe secondhand smoke are more likely to die unexpectedly from sudden infant death syndrome (SIDS), also called crib death, than babies who are not exposed to smoke from burning tobacco products.
  • Babies exposed to secondhand smoke in the womb or after birth are born and grow up with weaker lungs than babies that are not exposed to secondhand smoke.
  • Babies and children who breathe secondhand smoke are sick more often with bronchitis, pneumonia, and ear infections than those that are not exposed to secondhand smoke.
  • For children with asthma, breathing secondhand smoke can trigger an asthma attack.

How Secondhand Smoke Harms AdultsEven if you have never smoked, secondhand smoke can still cause

    • Heart disease
    • Lung cancer
    • Stroke

Thirdhand smoke is the chemical residue that is left behind on clothes, skin, furniture, walls, and other surfaces after someone smokes. Thirdhand smoke is also known as “tobacco smoke residue” or “stale tobacco smoke”. The mixture of pollutants in thirdhand smoke is toxic to humans, especially children.

Thirdhand smoke is the chemical residue left behind by secondhand smoke that can linger for years in dust, on household surfaces and can become embedded in carpets, furniture, fabrics, and building materials. 

THS can be found in almost all indoor environments where tobacco has been smoked: homes, cars, hotels, casinos, on the hands of smokers, on the hands of nonsmokers, in dust, on surfaces, in the air, in pillows, shirts, blankets, toys, upholstery, on doors, the underside of tables, embedded in furniture, ceiling tiles, drywall, carpets, carpet padding, etc.