After years of declared victories, Cuyahoga County's public health advocates and leaders fear that once again they are losing the battle against smoking.

The county's smoking rates had fallen to less than 19 percent of residents in 2007. But that rate is back up to about 24 percent. And in in some Cleveland neighborhoods, more than 30 percent of adults smoke.

For Cleveland City Councilman Joe Cimperman, the statistics are a call to action.

"Our goal is to change the culture of smoking in Cleveland and if people have a problem with that than that's good," Cimperman says. "People should have a problem with people dying too soon from diseases like emphysema and lung cancer."

The city had already banned cigarette smoking in publicly-owned outdoor areas such as parks, community gardens, and within 150 feet of public places like City Hall and the convention center. Now, that law extends to e-cigarettes.

Nigel Aviles, who sells e-cigarettes at Record Revolution in Cleveland Heights, rolls his eyes when he hears the new rules.

"It helps people to stop smoking traditional cigarettes. They wean off of it through various dosages of nicotine," Aviles says.

Executives in the e-cigarette industry have said the product can help people quite tobacco. But Cuyahoga County's Health Commissioner Terry Allan says there's no definitive proof and disagrees.

Instead, Allan says, e-cigarettes are another way to become addicted to nicotine.

"Public health people see e-cigarettes as a renormalization of tobacco use. It's a tobacco product," Allans says. "And we consider it a tobacco product."

Other cities that have banned smoking e-cigarettes include New York and Chicago. And, closer to home, Lakewood banned the sale of e-cigarettes to minors earlier this summer.