Teen tobacco use remains at historically low levels, but the popularity of electronic cigarettes continues to rise as lawmakers debate whether to regulate their use.

In its latest report, the U.S. Centers for Disease Control and Prevention (CDC) states that e-cigarette use increased from 2.46 million middle and high school students in 2014 to 3 million in 2015.

The report with the results from the 2015 National Youth Tobacco Survey is the annual snapshot that looks at children’s tobacco use.

A total of 4.7 million middle and high school students reported using a tobacco-related product within the past month. Half of them reported using more than one type.

CDC Director, Dr. Tom Frieden, says e-cigarettes are now the most commonly used tobacco product among youth.

“No form of youth tobacco use is safe,” he said in a press release. “Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”

The use of cigarettes and e-cigarettes, also referred to as “vaping,” remain the most popular options. Students also report using smokeless tobacco as well as cigars and hookahs.

Ninety percent of all adult smokers report first starting in their teens. Officials at the CDC and other regulatory agencies remain concerned that one in four students reports using some kind of tobacco product.

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The Push to Regulate E-Cigarettes

The U.S. Food and Drug Administration (FDA) regulates certain forms of tobacco, such as cigarettes and loose and smokeless tobacco. However, newcomers to the field, namely manufacturers of e-cigarettes, are currently fighting to avoid falling under that umbrella.

Under the Federal Food, Drug, and Cosmetic Act, the FDA has authority to regulate tobacco products. Two years ago, the agency sent a letter to the White House about its proposed rule to include e-cigarettes, hookahs, and cigars under its regulatory authority.

The FDA sent its recommendations to the White House on Oct. 19. It came with a 90-day limit for the Office of Management and Budget to review, but it’s now been six months.

Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products, said the agency is “deeply concerned” with the rates children use tobacco, including hookahs and e-cigarettes.

“Finalizing the rule to bring additional products under the agency’s tobacco authority is one of our highest priorities, and we look forward to a day in the near future when novel tobacco products like e-cigarettes and hookahs are properly regulated and responsibly marketed,” he said in a press release.

The FDA is expected to release its decision this month regarding how e-cigarettes are regulated, including how they’re advertised and marketed.

There are concerns about what this would do to the growing e-cigarette market, namely regarding a provision that may or may not grandfather in products on the market before 2007 under the Tobacco Control Act

If put under FDA regulation, these new products would be put under the same scrutiny as cigarettes, mainly restricting sales and marketing to minors.

Thirty groups, including the Campaign for Tobacco-Free Kids, sent a letter to President Barack Obama earlier this week urging that all tobacco and other products containing nicotine be put under FDA approval.

“The consequences of not quickly applying FDA’s regulatory authority to all tobacco products have been serious. In the absence of regulation, we have seen irresponsible marketing of unregulated products such as cigars and electronic cigarettes and the use of sweet flavors that clearly appeal to youth,” the letter states. “E-cigarettes come in more than 7,000 flavors, including cotton candy, gummy bear, bubble gum, and other flavors that appeal to kids. It’s no wonder use of e-cigarettes by youth has skyrocketed.”

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Tactics Similar to Tobacco

Vince Willmore, vice president of communications for Campaign for Tobacco-Free Kids, said the tactics e-cigarette companies are using now are the same as tobacco companies, which is one reason they should be regulated as such.

“These unregulated products are very popular among children. Flavors help those products appeal to children,” he told Healthline. “Many e-cigarettes come in bright colors and packaging that appeal to kids. We really can’t afford any more that affects the health of children.”

Meanwhile, industry-funded groups like the National Center for Public Policy Research (NCPPR) and the American Enterprise Institute are urging Congress to step in before the FDA makes its ruling. They argue the changes would damage the e-cigarette industry.

“The regulation would have the effect, intended or not, of taking e-cigarettes away from former smokers who quit smoking by using these less harmful alternatives, NCPPR risk analysis director Jeff Stier said in a press release issued Thursday. “This is exactly the opposite of what government should be doing, which is to create a regulatory environment that encourages smokers to switch to e-cigarettes, the dramatically less harmful way to get nicotine.”

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