Elizabeth Renstrom for TIME
By Alexandra Sifferlin
January 5, 2016
TIME Health
For more, visit TIME Health.

Close to 7 in 10 middle and high schoolers are exposed to ads for e-cigarettes, according to a new federal report.

The new study, published Tuesday, uses data from the 2014 National Youth Tobacco Survey and reports that close to 69% of American middle- and high-school students are exposed to e-cigarettes ads from at least one source, with around 55% seeing them in stores, 40% seeing them online, 37% seeing them in movies or on TV, and 30% seeing ads in newspapers or magazines.

In all, the Centers for Disease Control and Prevention (CDC) reports that around 18 million U.S. young people see e-cigarette advertising—something the agency’s director finds troubling.

“The same advertising tactics the tobacco industry used years ago to get kids addicted to nicotine are now being used to entice a new generation of young people to use e-cigarettes,” said CDC director Dr. Tom Frieden in a statement.

MORE: The Butter Flavor Chemical Used in Microwave Popcorn Is Also in E-Cigs

A graphic accompanying the report shows e-cigarette use among young people to be on the rise, which is happening in tandem with the increase in teen exposure to advertising. According to the report, advertising spending for e-cigarettes has increased from around $6.4 million in 2011 to $115 million in 2014.

CDC

The study authors report that teens were less likely to see ads for e-cigs than ones for regular tobacco in retail locations—but exposure to ads online or in print were comparable.

“Advertising for conventional tobacco products…has been shown to prompt experimentation as well as increase and maintain tobacco product use among youths,” the study authors write.

There remains a lack of consensus concerning the risks and benefits of e-cigarettes. Proponents for e-cigs argue they’re healthier than conventional cigarettes, but other research indicates chemicals in e-cigarettes can be dangerous to inhale. Both products contain nicotine, which is addictive.

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