San Francisco has become the first city in the United States to completely ban the sale (both online and in brick-and-mortar stores) of all types of e-cigarettes to stanch what it sees is an epidemic of youth vaping.

The San Francisco Board of Supervisors unanimously voted 11-0 in favor of the ordinance to this effect on Thursday. The ordinance says "no person shall sell or distribute an electronic cigarette to a person in San Francisco" unless this product has undergone premarket review by the U.S. Food and Drug Administration (FDA). No e-cigarette has been approved for use by the FDA, however.

San Francisco’s ban includes sales in physical stores and online sales shipped to San Francisco addresses. The ordinance also prohibits flavored tobacco products.

"This is a decisive step to help prevent another generation of San Francisco children from becoming addicted to nicotine," said City Attorney Dennis Herrera.

The ordinance still has to be signed by Mayor London Breed but she’s expressed her support for the measure before. After Mayor Breed signs it, the ordinance takes effect 30 days later and will be fully implemented six months after that.

“We need to take action to protect the health of San Francisco’s youth and prevent the next generation of San Franciscans from becoming addicted to these products,” said Mayor Breed.

She said e-cigarette companies “are targeting our kids in their advertising and getting them hooked on addictive nicotine products.”

San Francisco has long criticized the FDA for allowing e-cigarettes to remain on sale without reviewing their impact on public health. Health activists say San Francisco’s ordinance is a rebuke of the FDA’s failure in this regard.

"E-cigarettes are a product that by law are not allowed on the market without FDA review," argues Herrera. "For some reason, the FDA has so far refused to follow the law."

And because of this inaction, "youth vaping is an epidemic," claims Herrera. "If the federal government is not going to act to protect our kids, San Francisco will."

Juul Labs Inc., which controls over 70 percent of the U.S. e-cigarette market, criticized San Francisco’s action.

Juul claims the ban will “drive former adult smokers who successfully switched to vapor products back to deadly cigarettes, deny the opportunity to switch for current adult smokers, and create a thriving black market instead of addressing the actual causes of underage access and use.”

E-cigarette use among U.S. high school students skyrocketed 78 percent in 2018, according to federal government data.