Advocates are still working to raise the age to buy tobacco products from 18 to 21 years old.
22 localities across New York State have passed similar legislation.
Monroe County's Agenda Charter Committee will meet Monday night to vote on the bill.
Caitlin O'Brien, Government Relations Director for the American Heart Association says is essential to curb young smoking.
She is in Rochester for the meeting, and says while the rates of adult smoking are okay these days; rates in young people are skyrocketing due to the popularity of e-cigarettes.
She says they know most young people get cigarettes and tobacco products from slightly older friends, but if they raise the age, that would be less likely.
"A lot of 13 year olds, 14 year olds, 15 year olds know and go to school with or are in the same house with 18 year olds, but that’s not necessarily the case with 21 year olds."
O'Brien says in terms of backlash to their push, some people have brought up the military analogy: if you can serve in the military, you should be able to smoke a cigarette.
If the bill passes the Agenda Charter Committee tonight, it would move to the full county legislature for a vote.
O'Brien says they are disappointed that the state did not pass Tobacco 21 while they were in session, and says localities now need to "step up where the state failed to."