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Responding to an enormous increase in teens vaping nicotine, Somerville has become the first municipality in Massachusetts to restrict the sale of e-cigarettes, a step that could prompt other cities and towns to take similar action.

The local Board of Health voted this month to ban the sale of e-cigarettes and menthol cigarettes in stores that are open to youths, a move that will effectively pull the products from convenience store shelves.

Beginning April 1, 2019, sales of menthol and e-cigarettes will be allowed only in tobacco stores open to customers over age 21.

The regulation comes amid growing concern that e-cigarettes such as Juul, promoted as a way to help adults quit smoking traditional cigarettes, have instead launched an epidemic of teens addicted to inhaling nicotine from the sleek, electronic devices.

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The Centers for Disease Control and Prevention reported last month that more than 3.6 million young people nationwide, including 1 in 5 high school students and 1 in 20 middle school students, use e-cigarettes.

In Somerville, the number of teens who reported using e-cigarettes has also spiked, almost doubling between 2016 and 2018, even as the use of alcohol and traditional cigarettes declined, according to the city’s Youth Risk Behavior Survey.

Although teens often regard e-cigarettes as relatively harmless, the surgeon general has labeled e-cigarette use among youths an “epidemic” and warned that nicotine exposure during adolescence can cause addiction and harm the developing adolescent brain.

“I think what Somerville has done will pave the way for many others to follow,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, who added that San Francisco and Minneapolis are among several other cities that have adopted similar restrictions. “It is a smart, thoughtful step while allowing adults who already smoke to get access to products.”

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Dennis Lane, executive director of the Coalition for Responsible Retailing, which represents convenience stores, gas stations, auto repair shops, and retailers, said Somerville’s action comes after it previously raised the age for tobacco sales to 21 and banned flavored tobacco, steps that did not curb the increasing rate of vaping by teenagers.

He said Somerville retailers have a 99.2 percent compliance rate with tobacco sales laws this year, which shows local retailers are not to blame for teens using e-cigarettes.

“Instead of taking away adults’ rights, health officials should be addressing the gaping loophole in Massachusetts law that legally allows minors to possess and use tobacco, unlike alcohol and marijuana, regardless of how they obtain it,” Lane said. “Retailers have already been doing our part to address this issue.”

Somerville’s action follows a new focus on youth smoking on Beacon Hill. Earlier this year Governor Charlie Baker signed into law a measure raising the legal age to buy tobacco products — including e-cigarettes from 18 to 21. That law takes effect Dec. 31.

Health officials have expressed concern that e-cigarettes and menthol cigarettes are particularly attractive to teens because they are flavored.

But Michael Siegel, a professor of community health sciences at Boston University, questioned why Somerville targeted only menthols, which he said account for about 40 percent of cigarette use among young people.

“I don’t see how you can justify Marlboros being sold, but not Newports,” he said. “How does that make any public health sense?”

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By not evenly regulating all cigarettes, he said, the city is also potentially inviting litigation from the tobacco or retail industries, which could argue the regulation is arbitrary.

“What we need is to have a level playing field so cigarette companies aren’t given an advantage,” Siegel said.

Ted Kwong, a Juul spokesman, declined to comment on Somerville’s regulation, but pointed to steps the company has taken to combat youth usage.

He noted that Juul expressed support for the new legal age to purchase tobacco products. And he said Juul last month stopped selling certain flavors — mango, fruit, creme, and cucumber — that critics said appealed to teens.

Myers, however, said Juul continues to sell mint and menthol flavors, which account for 50 percent of all teen use. “Like many statements made by Juul, it sounds better than it is,” he said.

Joseph Allen, a professor at Harvard’s T.H. Chan School of Public Health, said the flavoring chemicals used in e-cigarettes were linked more than a decade ago to lung disease in workers who handled them in a popcorn packaging factory. And the workers who handle them are now warned about the potential dangers, he said.

“Why don’t e-cig users [get the same warnings?]” he said. “You have millions of kids in particular who are gaining access to these flavoring chemicals and what we know is they’re not necessarily safe.”


Michael Levenson can be reached at mlevenson@globe.com. Follow him on Twitter @mlevenson.

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