A new study has found that 4.6 million young people — a quarter of all high school students and nearly 8 percent of middle school students —used tobacco in some form last year. According to the study, there was a decline in the numbers of high school students smoking cigarettes (from 16 percent to 9 percent), as well as a decline in  the use of cigars and pipes. However, the study found that there was a substantial increase in the use of e-cigarettes (9.4 percent) and hookah pipes (13.4 percent ) that led to 400,000 additional young people using tobacco products in 2014.

The survey, published in the Morbidity and Mortality Weekly Report, asked 22,000 middle and high school students about their tobacco usage over a 30-day period. The overall results were roughly consistent with recent years, with 24.6 percent of high school students and 7.7 percent of middle school students saying they had used some form of tobacco in 2014.

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. E-cigarettes were the most used tobacco product for non-Hispanic whites, Hispanics, and non-Hispanic other races, while cigars were the most commonly used product among non-Hispanic blacks.

The California Department of Public Health (CDPH) recently published a report that found that California e-cigarette use among young adults ages 18 to 29 had tripled in one year. CDPH also determined  that secondhand smoke from e-cigarettes is a public health threat, with at least 10 carcinogens present in its vapor, including nickel and other heavy metals, as well as formaldehyde and benzene.

The report also found that the availability of e-cigarettes in a variety of candy and fruit flavors such as cotton candy, gummy bear, chocolate mint and grape made these products highly appealing to young children and teens. Among children up to 5 years old, e-cigarette poisonings increased sharply from only seven in 2012 to 154 in 2014. By the end of 2014, e-cigarette poisonings in young children tripled in one year, making up more than 60 percent of all e-cigarette poisoning calls.

Click here to read the report.