E-cigarettes are the tobacco product of choice for middle and high schoolers, according to a new study.

The 2014 National Youth Tobacco Survey, conducted by the Centers for Disease Control and Prevention and the Drug Administration's Center for Tobacco Products, shows use (which the survey defined as smoking at least one day a month) of e-cigarettes among high school students severely increased from 4.5 percent in 2013 to 13.4 percent in 2014. The rate more than tripled from 1.1 percent to 3.9 percent for middle school-aged kids over the same period.

For the same demographic, hookah came in as the the second most popular tobacco product. Use among the age group increased from 5.2 percent to 9.4 percent.

Overall tobacco use among high schoolers climbed from 22.9 to 24.6 percent.

The results are troublesome for advocates of tobacco control.

"We want parents to know that nicotine is dangerous for kids at any age, whether it's an e-cigarette, hookah, cigarette or cigar," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said in a statement. "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."

Frieden believes that e-cigarette use is on the rise thanks in part to television adds. Traditional cigarette ads have not been allowed to be televised since 1971.

"Marketing is about sex, flavors, free samples," he said, according to U.S. News and World Report. "Although cigarette ads ... haven't been on TV since 1971, kids are now seeing e-cigarettes on TV ... including themes of glamour, rebellion, celebrity, sports, music events, candy and fruit flavors." 

Anti-smoking advocates are also using the results to call on the FDA to finally starts regulating e-cigarettes.

"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," Mitch Zeller, J.D., director of FDA's Center for Tobacco Products, said in a statement. "These staggering increases in such a short time underscore why FDA intends to regulate these additional products to protect public health."

The survey was given to 22,000 students.