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China plans to ban e-cigarettes in public places to stem a “distinct increase” in vaping among teenagers, the latest sign of pushback against a nascent industry that was seeking a foothold in the world’s largest tobacco market.

A week after it banned all online sales of e-cigarettes, a document issued Thursday by eight government bodies, including the National Health Commission, laid out an action plan to combat smoking and vaping among teenagers.

The document, while urging a use of legislation, law revision and enforcement to ban e-cigarettes in public places, did not elaborate on when and how the ban will take effect.

China Bans E-Cigarette Sales Online to Protect Teenagers

China’s moves are the latest restriction on an industry whose fortunes have soured rapidly in the past few months as a mysterious lung disease linked to vaping has hurt 1,888 people and killed 37.

“There is currently no clear evidence that e-cigarettes can help people quit smoking,” the document said. “Authorities must not allow e-cigarettes to be marketed or advertised as smoking cessation tools.”

That stance aligns China with countries that have banned e-cigarettes outright, including India, Brazil and Singapore. In contrast, some nations like the U.K. view e-cigarettes as viable alternatives to smoking, one of the leading causes of preventable death. A survey released by the World Health Organization in July showed over 90% respondents in China supporting smoke-free indoor places. This included both cigarettes as well as e-cigarettes.

Proliferation

China’s e-cigarette market size rose from $451 million in 2016 to $718 million in 2018, according to estimates from L.E.K. Consulting, as lack of specific regulations in the past on e-cigarettes allowed for their proliferation.

The government document stresses the need to create smoke-free environment, whether from traditional cigarettes or vaping devices, in and around schools and “seriously investigate” the illegal sale of smoking products in the schools’ vicinity. China banned sales of e-cigarettes to people under 18 years old in August last year.

“We are very concerned with youth smoking as sale of cigarettes around schools is common,” said Gan Quan, New York-based director of tobacco control at The Union, a non-profit that provides policy making support for developing nations’ health ministries. Enforcement of the ban on sale to minors in China has been “very poor,” he said.

Vaping-Lung Deaths Rise Again as Culprit Remains Elusive

Once thought of as a useful tool to help smokers quit cigarettes, e-cigarettes are now being seen as just as harmful. They are now banned by over 20 countries, while Juul Labs Inc., the largest U.S. e-cigarette company, has been probed for marketing to teenagers.

Michael R. Bloomberg, the founder and majority owner of Bloomberg News parent Bloomberg LP, has campaigned and given money in support of a ban on flavored e-cigarettes and tobacco.