The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) analyzed data from the 2011-2014 National Youth Tobacco Surveys to determine the prevalence and trends of current use of nine tobacco products among middle and high school students. What they found was that e-cigarette use tripled among middle and high school students in just one year, 2013-2014. Hookah use doubled overall. And there was no decline seen in overall tobacco use among middle or high school students.

The results were published by the CDC in today’s Morbidity and Mortality Weekly Report.

Findings from the 2014 National Youth Tobacco Survey show that current e-cigarette use (use on at least one day in the past 30 days) among high school students increased from 4.5 percent in 2013 to 13.4 percent in 2014, rising from approximately 660,000 to 2 million students. Among middle school students, current e-cigarette use more than tripled from 1.1 percent in 2013 to 3.9 percent in 2014—an increase from approximately 120,000 to 450,000 students.

This is the first time since the survey started collecting data on e-cigarettes in 2011 that current e-cigarette use has surpassed current use of every other tobacco product overall, including conventional cigarettes.

“We want parents to know that nicotine is dangerous for kids at any age, whether it’s an e-cigarette, hookah, cigarette or cigar,” said CDC Director Tom Frieden, M.D., M.P.H., in a news release. “Adolescence is a critical time for brain development. Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use.”

Hookah use roughly doubled for middle and high school students, while cigarette use declined among high school students and remained unchanged for middle school students.

The increases in e-cigarette and hookah use offset declines in use of more traditional products such as cigarettes and cigars, the report found.

In 2014, the products most commonly used by high school students were e-cigarettes (13.4 percent), hookah (9.4 percent), cigarettes (9.2 percent), cigars (8.2 percent), smokeless tobacco (5.5 percent), snus (1.9 percent) and pipes (1.5 percent).

The survey also found that use of multiple tobacco products was common; nearly half of all middle and high school students who were current tobacco users used two or more types of tobacco products.

The products most commonly used by middle school students were e-cigarettes (3.9 percent), hookah (2.5 percent), cigarettes (2.5 percent), cigars (1.9 percent), smokeless tobacco (1.6 percent), and pipes (0.6 percent).

Cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco are currently subject to the FDA’s tobacco control authority. The agency currently is finalizing the rule to bring additional tobacco products such as e-cigarettes, hookahs and some or all cigars under that same authority. Several states have passed laws establishing a minimum age for purchase of e-cigarettes or extending smoke-free laws to include e-cigarettes, but Mitch Zeller, director of FDA’s Center for Tobacco Products, said on a conference call about the report that more needs to be done and coalitions need to ensure that comprehensive tobacco control and prevention strategies for youth focus on all tobacco products.

“In today’s rapidly evolving tobacco marketplace, the surge in youth use of novel products like e-cigarettes forces us to confront the reality that the progress we have made in reducing youth cigarette smoking rates is being threatened,” Zeller said. “These staggering increases in such a short time underscore why FDA intends to regulate these additional products to protect public health.”

The full report can be found here.

SEE ALSO:

Why E-cigarettes Have Some People All Choked Up

CADCA’s Prevent Tobacco Use Toolkit

E-Cigarette Exposure Impairs Immune Responses in Mouse Model, New Research Finds