In a move described as an effort to keep a questionable product out of the hands of young people, San Francisco supervisors last week moved a step closer to becoming the first city in the U.S. to ban all sales of electronic cigarettes.

Supervisors unanimously approved a ban on the sale and distribution of e-cigarettes. They also endorsed a ban on manufacturing of e-cigarettes on city property.

The Associated Press reported that supervisors acknowledged that the legislation would not entirely prevent youth vaping, but they hoped it would be a start.

According to a U.S. government survey reported by the Centers for Disease Control and Prevention last November, e-cigarettes entered the U.S. marketplace in 2007 and by 2014 were the most commonly used tobacco product among U.S. youth.

Since 2014, the popularity of e-cigarettes has grown among young people in the country. Last year, 1 in 5 U.S. high school students reported vaping in the previous month, a 78% increase during 2017-2018.

Among high school students, current use of any flavored e-cigarettes increased among current e-cigarette users from nearly 61% to nearly 68%. Among middle school students, current e-cigarette use increased from 0.6% in 2011 to 4.9% in 2018.

The government reported noted, “Although e-cigarettes have the potential to benefit adult smokers if used as a complete substitute for combustible tobacco smoking, the use of any form of tobacco product among youths, including e-cigarettes, is unsafe. The Surgeon General has concluded that e-cigarette use among youths and young adults is of public health concern; exposure to nicotine during adolescence can cause addiction and can harm the developing adolescent brain.”

San Francisco City Attorney Dennis Herrera said young people “have almost indiscriminate access to a product that shouldn’t even be on the market.” Because the Food and Drug Administration has not yet completed a study to assess the public health consequences of e-cigarettes and approved or rejected them, “it’s unfortunately falling to states and localities to step into the breach.”

FDA spokesman Michael Felberbaum said in a statement that the agency will continue to fight e-cigarette use, including preventing youth access.

Juul, a leading San Francisco-based e-cigarette company frames vaping as a healthier alternative to smoking tobacco, with a company spokesman noting that Juul has taken steps to deter children from using its products.

Juul spokesman Ted Kwong told The AP, “The prohibition of vapor products for all adults in San Francisco 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.”

Juul has already contributed $500,000 to the Coalition for Reasonable Vaping Regulation, which is working to gather signatures to put an initiative on the issue before the city’s voters.

The American Vaping Association also opposes San Francisco’s proposal, noting adult smokers deserve access to less hazardous alternatives.

Stanton Glantz, a professor of medicine at the University of California San Francisco Center for Tobacco Control and Research, told The AP that e-cigarettes are associated with heart attacks, strokes and lung disease.

The presence of e-cigarettes, he said, has “completely reversed the progress we’ve made in youth smoking in the last few years.”

The San Francisco ban does little but underscore the need for definitive recommendations from the FDA.

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