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9.A. - Page 13 of 31 ORDINANCE NO.. BOARD OF SUPERVISORS, COUNTY OF SAN MATEO, STATE OF CALIFORNIA AN ORDINANCE ADDING A NEW CHAPTER 4.95 TO TITLE 4 OF THE SAN MATEO COUNTY ORDINANCE CODE TO PROHIBIT THE SALE OR DISTRIBUTION OF ELECTRONIC CIGARETTES The Board of Supervisors of the County of San Mateo, State of California, ORDAINS as follows: SECTION 1. Findings. The Board of Supervisors finds and determines that: (a) Electronic smoking device (or "e -cigarette, vape, vape pen, e -hookah, etc.") usage by youth has been rising. Usage by high school students increased 78% between 2017-2018 with 1 in 5 high school students currently using and 1 in 20 middle school students currently using the products.' The devices were available in the U.S. marketplace in the mid -2000s2 and, by 2014, the products were the most commonly used tobacco product among middle and high school students.3 (b) According to the Centers for Disease Control and Prevention ("CDC"), the number of middle and high school students who reported being current users of tobacco products increased 36%—from 3.6 million to 4.9 million students—between 2017 and 2018. This dramatic increase, which has erased past progress in reducing youth tobacco use, is directly attributable to a nationwide surge in e -cigarette use by adolescents. There were 1.5 million more youth e -cigarette users in 2018 than 2017, and those who were using e -cigarettes were using them more often. Frequent use of e -cigarettes increased from 20 percent in 2017 to 28 percent in 2018 among current high school e -cigarette users. (c) In 2016, it was estimated that 20.5 million (4 in 5) middle and high school students in the U.S. were exposed to advertisements for e -cigarettes from 1 Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students – United States, 2011-2018. MMWR Morb Mortal Wkly Rep 2018;67:1276-1277. DOI: http://dx.doi.org/10.15585/nunwr.mm6745a5 2 US Department of Health and Human Services. E -cigarette use among youth and young adults: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2016. https://ecigarettes.surgeongeneral.gov/documents/2016–SGR_Full_Report non-508.pdfpdf icon s Arrazola RA, Singh T, Corey CG, et al. Tobacco use among middle and high school students—United States, 2011-2014. MMWR Morb Mortal Wkly Rep 2015;64:381-5. PubMedexternal icon 290