San Francisco is set to become the first major U.S. city to ban e-cigarettes after city supervisors voted unanimously in favor of the ordinance on Tuesday. A final vote to pass the measure is expected next week.

San Francisco's Board of Supervisors approved an ordinance amending the health code to prohibit the sale, manufacture, and distribution of tobacco products, including electronic cigarettes, on city property. The measure specifically singled out the use of electronic cigarettes, blaming the devices for a "growing health epidemic of youth vaping."

A city ordinance in San Francisco requires two readings and will have to pass a second vote next week before it can be put into effect. The supervisors expressed concerns Tuesday about the impact on small businesses and said they planned to create a working group to aid them if the measure passes, according to NBC Bay Area.

A Centers for Disease Control and Prevention study from February stated that about 4.9 million middle and high school students were vaping in 2018, up from 3.6 million the year before. CDC Director Robert R. Redfield said when the study released that the country must help keep kids safe from a preventable health risk.

“The skyrocketing growth of young people’s e-cigarette use over the past year threatens to erase progress made in reducing youth tobacco use," Redfield said. "It’s putting a new generation at risk for nicotine addiction."

San Francisco's proposed ordinance expands on a 2014 measure which banned the sale of such devices where the sales of traditional tobacco products are already prohibited.

E-cigarette company Juul, which is based in San Francisco, frames vaping as a healthier alternative to smoking tobacco. Juul has said it has taken steps to deter children from using its products. The company said in a statement that it has made its online age-verification process more robust and shut down its Instagram and Facebook accounts to try to discourage vaping by those under 21 years old.

"But 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," said Juul spokesman Ted Kwong.

San Francisco's measure also sets the stage for a November ballot fight over e-cigarettes. Juul has already contributed $500,000 to the Coalition for Reasonable Vaping Regulation, which is set to gather signatures to put an initiative on the issue before voters.

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