regulated. it is possible that e-cigarette regulation will effect marketing. tighter regulations for the marketing and advertising of e-cigarettes has been recommended. ways to minimize the scope of the tobacco epidemic include strongly reinforcing current tobacco control measures. this includes tighter regulations for advertising. it is recommended that regulatory measures should be implemented for e-cigarettes or nicotine-containing products because of the adverse effects of nicotine exposure on the developing human brain. to cut down the possible adverse consequences concerning prevention and quitting smoking and the undoing of existing tobacco control strategies, it is strongly recommended vaping be banned where traditional cigarettes are banned, and they be put under the same marketing limitations as traditional cigarettes. a 2016 world health organization report suggested prohibiting or limiting advertising, promotion, and sponsorship of e-cigarettes. regulation of the production and promotion of e-cigarettes may help lower some of the adverse effects associated with tobacco use. a 2017 review stated, "in the absence of conclusive evidence of safety and the health impact of the use of the e-cigarette, it is recommended that there should be restrictions on advertising of e-cigarettes, especially e-liquids of fruit and sweet flavors which are particularly likely to encourage young people to start using the e-cigarette." whether e-cigarettes reduce or increase health risks relies on an intricate and changing interactivity among the businesses marketing e-cigarettes, users, regulators, and scientists, among other things. assertions of effectiveness as a quitting smoking tool have been seen in e-cigarette advertisements in the us, uk, and china, despite such assertions had not been supported by regulatory bodies. e-cigarettes containing nicotine have been listed as drug delivery devices in a number of countries, and the marketing of such products has been restricted or put on hold until safety and efficacy clinical trials are conclusive. e-cigarettes and the marketing and regulatory landscape are quickly changing, all of which may impact the connection between vaping and giving up smoking. tobacco businesses have partnered with organizations formed to promote vaping, including the electronic cigarette association, consumer advocates for smoke-free alternatives association, and vapers international, inc. these establishments, and other interested parties, have made an effort to impede or put an end to legislation intended at restricting their sale and use. united states a nicotine warning statement for vaping products sold in the us a 2016 report found "in 2013, third-party organizations including industry-funded think tanks, business organizations (eg, chambers of commerce), and hospitality associations, as well as front groups, started opposing efforts to include e-cigarettes in existing retail licensing and smokefree laws." in 2015, there was limited restrictions in the us on the marketing of e-cigarettes. since they do not contain tobacco, television advertising in the us was not restricted in 2015. in 2016 in the us, e-cigarettes were not mandated to undergo testing prior to marketing. a 2015 review strongly recommended marketing restrictions in the us to prevent intended and unintended advertising and promotion of these products to young people, particularly those who are non-smokers or are below the minimum smoking age. examples of marketing restrictions the review recommended were prohibiting sponsoring events, concerts, and sporting events frequented by youth. the tobacco master settlement agreement forbids tobacco companies from using cartoon characters in the us, but no such law has been enacted in the us for e-cigarettes, as of 2019. after proposing the "deeming rule" in 2014, the us fda began regulating the manufacturing, marketing, and sales of e-cigarette products as tobacco products in 2016. the manufacturing, marketing, and sales of e-cigarette products in the us were not under the jurisdiction of federal regulations until may 2016 when the us fda published its finalized deeming rule, granting the us fda federal regulatory authority over e-cigarettes, cigars, and hookah tobacco products equivalent to the rules in place for traditional cigarettes and smokeless tobacco. the us fda regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of e-cigarettes. this includes components and parts of e-cigarettes but excludes accessories. effective may 10, 2018, vape shop retailers were prohibited from selling or distributing e-cigarettes or other vape products without including a health warning statement on the product packaging and from displaying e-cigarette or other vape product advertisements without including a health warning statement on the advertisements. internet marketers have advocated that trying to regulate vaping in the us would constrain innovation and restrict choices for people trying to give up smoking. a 2010 us district court decision blocked e-cigarette manufacturers from marketing e-cigarettes as quit-smoking devices. however, advertisers use indirect tactics such as affiliate marketing to circumvent that decision; claims about the products' health and safety profile and their role in smoking cessation may be commonplace on social networks despite the ruling. e-cigarettes are often marketed and displayed on countertops near till points and next to products of particular interest to children and adolescents; this may lead to the embracing of e-cigarettes as a broadly used and accepted product. however, several us jurisdictions have passed laws that increased the minimum age of sale for all tobacco products, including e-cigarettes, to 21 years. the family smoking prevention and tobacco control act of 2009 which is a federal statute in the us, banned the sale of cigarettes with flavors except for menthol and tobacco. the law did not disallow other flavored tobacco products. in 2017, the marketing of flavored non-cigarette tobacco products was widely permitted, and the tobacco industry persistently introduced non-cigarette products in new flavors. in the last few years leading up to 2017, tobacco makers have substantially increased the marketing of non-cigarette tobacco products containing flavors. this includes e-cigarettes and cigars. in 2017, san francisco passed a ruling to ban the sales of all flavored nicotine products. this law originated from concerns that these flavored products are directly aimed at youth and people of color. reynolds tobacco company began gathering signatures to suspend the ruling before it became law. an adequate number of signatures were collected to put the ruling to a public vote in front of san francisco voters. despite $12 million being spent mostly by r. j. reynolds tobacco company against the ban, san francisco voters passed a measure known as proposition e that effectively bans the sale of flavored tobacco products, including flavored e-liquids on june 5, 2018. they are the first city in the us to enact such a ban. it passed by a 68% to 32% margin and it became law on july 20, 2018. the american lung association said that "san francisco's youth are routinely bombarded with advertising for flavored tobacco and e-cigarettes every time they walk into a neighborhood convenience store. it's clear that these products with candy themes and colorful packaging are geared towards teens." supporters of proposition e stated that it would shield the children of san francisco from being marketed candy flavored tobacco products (including flavored e-liquids). opponents of proposition e stated that disallowing flavored tobacco products (including flavored e-liquids) would just not work and compared it to the lack of success for both the prohibition of alcohol and on the war on drugs to restrict marijuana use. in june 2019, city officials voted to approved an ordinance to ban the sale of e-cigarettes in san francisco, ca. in july 2019, mayor london breed signed the ordinance that effectively bans the sale of e-cigarettes. san francisco will be the first city in the us to outlaw the sale of these products. the ban will be implemented into law in early 2020, seven months after the ordinance was signed. in june 2019, the city officials voted in agreement to ban the sale of cigarettes, cigars, e-cigarettes and other tobacco products in beverly hills, ca, starting in 2021. effective on september 4, 2019, michigan plans on becoming the first state in the us to prohibit the sales of flavored nicotine vaping products. marketing messages such as "clean," "safe", and "healthy" are also part of the restriction for such products. "as governor, my number one priority is keeping our kids safe and right now, companies selling vaping products are using candy flavors to hook children on nicotine and misleading claims to promote the belief that these products are safe. that ends today," said michigan governor gretchen whitmer, on september 4, 2019. when fda commissioner scott gottlieb announced the fda's comprehensive plan for tobacco and nicotine regulation in july 2017, he made clear his concerns about youth use of e-cigarettes, especially those products marketed with obviously kid-appealing flavors. on november 15, 2018, scott gottlieb, directed the fda's center for tobacco products (ctp) to revisit this compliance policy as it applies to deemed e-cigarette products that are flavored, including all flavors other than tobacco, mint and menthol. the changes he seeks would protect youth by having all flavored e-cigarette products (other than tobacco, mint and menthol flavors or non-flavored products) sold in age-restricted, in-person locations and, if sold online, under heightened practices for age verification. these changes will not include mint- and menthol-flavored e-liquids, the fda stated. in 2018 the us fda decided to create new regulations to ban the sale of e-liquid flavors at convenience stores and gas stations, with the intent of decreasing the use of e-cigarettes among young people. tobacco, mint, and menthol flavors will still be allowed at convenience stores, gas stations, and other places where they are sold. fruity-type flavors can only be sold at places where adults shop, such as vape shops. in march 2019, nancy brown, ceo of the american heart association, stated, "the fda should prohibit companies from marketing their products in ways that appeal to kids. without immediate and urgent action pertaining to flavored tobacco products, the epidemic of e-cigarettes will continue to undo decades of progress in tobacco control." "under my leadership, the fda will continue to tackle the troubling epidemic of e-cigarette use among kids. this includes limiting youth access to, and appeal of, flavored tobacco products like e-cigarettes and cigars, taking action against manufacturers and retailers who illegally market these products or sell them to minors, and educating youth about the dangers of e-cigarettes and other tobacco products. we cannot and will not risk a generation of youth to a lifetime of nicotine addiction. we appreciate the ftc joining us on these and other actions to protect youth from the dangers of nicotine and tobacco products," said acting fda commissioner ned sharpless, m.d., in june 2019. in july 2019, the us fda launched its first television advertisement campaign aimed at preventing vaping among teens. "the real cost" campaign includes television commercials highlighting street magician julius dein usng illusions to inform teens about the drawbacks of vaping. on july 22, 2019, the us fda announced that these advertisements will run on television networks such as teennick, the cw, espn and mtv, as well as on music streaming sites, social media networks and other teen-focused media channels. europe the revised eu tobacco products directive came into effect may 2016, providing regulation for e-cigarettes. it limits e-cigarette advertising in print, on television and radio, along with reducing the level of nicotine in liquids and reducing the flavors used. this law does not pertain to products that do not contain nicotine such as e-cigarettes that do not contain nicotine. the law does not regulate posters, leaflets, or point of sale e-cigarette advertisements. it also does not regulate marketing materials that portray them as glamorous. promotion of e-cigarettes and e-liquids in print media, television, or radio media is banned. promotional materials on the packaging of such products is banned. advertising and promotion of e-cigarettes is banned in neighboring countries. the law still allows certain types of e-cigarette advertising such as posters, leaflets, and billboards in shops. a 2014 review stated that tobacco and e-cigarette businesses interact with consumers for their policy agenda. the businesses use websites, social media, and marketing to get consumers involved in opposing bills that include e-cigarettes in smoke-free laws. this is similar to tobacco industry activity going back to the 1980s. these approaches were used in europe to minimize the eu tobacco products directive in october 2013. general themes that were seen in marketing of e-cigarettes are health, lifestyle, and personalization. wordings implicating the product is a healthier alternative are often used in marketing, such as "natural," "food- or pharma grade," "homeopathic," and "made in switzerland." these terms refer to the plastics or