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In this Monday, June 17, 2019, photo, Jacky Chan, 23, takes a vaping break in San Francisco.The Associated Press

San Francisco will become the first major city in the United States to ban the sale of e-cigarettes as officials look to control the rapid uptick in teenage use of nicotine devices made by companies such as Juul Labs Inc.

The San Francisco Board of Supervisors approved the ordinance on Tuesday, banning the sale and distribution of e-cigarettes until they have approval from the U.S. Food and Drug Administration.

States and cities across the United States have already moved to ban flavoured e-cigarettes and raise the legal age for purchasing tobacco products to 21, but San Francisco’s new approach is the most far-reaching yet.

No other major cities have proposed a similar hard line ban, though San Francisco’s move could lead others to consider it.

The city council in Beverly Hills, California, this month approved a ban on the sale of tobacco products beginning 2021, though it carved out exceptions for some cigar lounges and hotels. Juul, which is based in San Francisco and has grown to be the dominant e-cigarette maker in the United States, has been at the centre of the debate. As its sales soared over the last two years, so did its popularity among teenagers.

Federal data last year showed a 78 per cent increase in e-cigarette use among U.S. high schoolers, and state and local lawmakers have been grappling with how to regulate Juul and other similar products.

San Francisco City Attorney Dennis Herrera, who spearheaded the ordinance earlier this year, praised the move and said it was necessary because of what he called an “abdication of responsibility” by the FDA in regulating e-cigarettes.

E-cigarette makers originally faced a 2018 deadline to submit applications to the FDA to sell products, but the deadline was pushed back several years.

“This lack of clarity is causing tremendous confusion at the same time that a whole new generation of young people are getting addicted to nicotine,” Herrera told Reuters. “The explosion in youth use and the health risks to young people are undeniable.”

In a statement before Tuesday’s vote, Juul said a ban “will not effectively address underage use and will leave cigarettes on shelves as the only choice for adult smokers, even though they kill 40,000 Californians every year.”

FDA spokesman Michael Felberbaum declined to comment on the San Francisco ban, but said the agency is “committed to continuing to tackle the troubling epidemic of e-cigarette use among kids,” including limiting access to flavoured e-cigarettes and cracking down on companies and retailers who sell to minors.

E-cigarettes are generally thought to be safer than traditional cigarettes, which kill up to half of all lifetime users, according to the World Health Organization, but the long-term health effects of the nicotine devices remain largely unknown.

San Francisco city officials last year approved a ban on flavoured tobacco and e-cigarette liquids, a move upheld by voters.

Juul last month filed paperwork in San Francisco for another ballot measure that experts say would make the flavour ban and Tuesday’s e-cigarette ban unenforceable.

If approved, the measure would put in place regulations favoured by Juul, which the company says would “ensure that underage access and use is addressed comprehensively but adults aren’t driven back to cigarettes.”

The e-cigarette ban will go into effect early next year, according to the city attorney’s office, and will apply to both online and brick-and-mortar sales in San Francisco.

City officials also passed a separate ordinance prohibiting the manufacture and distribution of all tobacco products on city property.

When the legislation was first proposed in March, Herrera said the city needed to prohibit e-cigarette sales until the FDA formally authorized the products.

E-cigarettes have existed in a regulatory grey area for years. The FDA in 2016 gave e-cigarette makers two years to submit applications, a deadline the agency pushed back to 2022. Amid the surge in teenage use, the FDA in March moved up that deadline to 2021.

A separate court case from anti-tobacco groups may force the FDA to set an earlier deadline.

Juul, in which Marlboro maker Altria Group has a 35 per cent stake, has already pulled popular flavours such as mango and cucumber from retail store shelves and shut down its social media channels on Instagram and Facebook.

The company also pledged to introduce technology that would better track underage use and hold retailers accountable for selling to minors.

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