San Francisco became the first major U.S. city to ban e-cigarettes after city supervisors unanimously passed the measure in a final vote Tuesday. The ban will go into effect 30 days after the mayor signs the ordinance.

San Francisco's Board of Supervisors approvedan ordinance to prohibit the sale of electronic cigarettes in the city until marketing for the devices are approved by the Food and Drug Administration. The board voted unanimously last week to approve the bill but a city ordinance in San Francisco requires two readings before it can be put into effect.

The measure specifically singled out the use of electronic cigarettes for presenting "significant public health consequence" to minors.

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."

The new measure passed along with a similar ordinance that bans the sale, manufacture and distribution of e-cigarettes on city property. San Francisco's newest measures expand on a 2014 measure which banned the sale of such devices where the sales of traditional tobacco products are already prohibited.

Supervisor Shamann Walton, who co-wrote the ordinance with the City Attorney and was its main sponsor, said in a statement Tuesday that the ban is until the FDA completes appropriate clinical trials and issues standards on e-cigarettes.

"As of now the FDA has not made a ruling on the safety and all health issues associated with e-cigarettes," Walton said. "In addition, the Board of Supervisors unanimously voted to never allow companies that sell, manufacture or distribute tobacco products, to lease any city property."

San Francisco Board of Supervisors Chair Norman Yee said that the ordinance was "not rocket science" and that the city will have the policy discussion again once the FDA reviews the full impact of e-cigarettes.

"Big tobacco has shown us their eagerness to prey on youth in order to grow their next generation of nicotine users," Yee said. "The full health impacts of these so-called 'safer alternatives' to traditional cigarettes is unknown – that’s a fact."

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.

Juul spokesman Ted Kwong said in a statement Tuesday that the city's ban will "create a thriving black market instead of addressing the actual causes of underage access and use." The company said it has taken steps to enhance its age verification process online and shut down its Facebook and Instagram accounts to restrict underage access.

"We are proposing a comprehensive set of new city regulations that require mandatory electronic scanning of IDs to verify age and ID validity to avoid human error, restrictions on bulk purchases to discourage unauthorized resale or sharing of products, city permits for all online vapor product retailers who wish to do business here, and increased restrictions on marketing for vapor products to name a few," Kwong said.

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.