San Francisco will become the first major city in the United States to ban the sale of e-cigarettes as officials look to control the rapid uptick in teenage use of nicotine devices made by companies such as Juul Labs Inc. 

The San Francisco Board of Supervisors approved the ordinance on Tuesday, banning the sale and distribution of e-cigarettes until they have approval from the U.S. Food and Drug Administration. 

States and cities across the United States have already moved to ban flavored e-cigarettes and raise the legal age for purchasing tobacco products to 21, but San Francisco’s new approach is the most far-reaching yet. 

No other major cities have proposed a similar hardline ban, though San Francisco’s move could lead others to consider it. 

Federal data last year showed a 78-percent increase in e-cigarette use among U.S. high schoolers, and state and local lawmakers have been grappling with how to regulate Juul and other similar products. 

San Francisco City Attorney Dennis Herrera, who spearheaded the ordinance earlier this year, praised the move and said it was necessary because of what he called an “abdication of responsibility” by the FDA in regulating e-cigarettes. 

E-cigarettes have existed in a regulatory gray area for years. Its makers originally faced a 2018 deadline to submit applications to the FDA to sell products, but the deadline was pushed back to 2022. 

Amid the surge in teenage use, the FDA in March moved up that deadline to 2021. A separate court case from anti-tobacco groups may force the FDA to set an earlier deadline. 

“This lack of clarity is causing tremendous confusion at the same time that a whole new generation of young people are getting addicted to nicotine,” Herrera told Reuters. “The explosion in youth use and the health risks to young people are undeniable.” 

FDA spokesman Michael Felberbaum declined to comment on the San Francisco ban, but said the agency is “committed to continuing to tackle the troubling epidemic of e-cigarette use among kids,” including limiting access to flavored e-cigarettes and cracking down on companies and retailers who sell to minors. 

E-cigarettes are generally thought to be safer than traditional cigarettes, which kill up to half of all lifetime users, according to the World Health Organization, but the long-term health effects of the nicotine devices remain largely unknown. 

The e-cigarette ban will go into effect early next year, according to the city attorney’s office, and will apply to both online and brick-and-mortar sales in San Francisco. 

City officials also passed a separate ordinance prohibiting the manufacture and distribution of all tobacco products on city property.