The U.S. Centers For Disease Control and Prevention (CDC) today released a report showing that the popularity of so-called “emerging tobacco products” is rising among middle and high school students. The CDC considers emerging tobacco products to include hookahs, little cigars, and e-cigarettes (though they are not technically tobacco products).

The report shows that 5.4% of high schoolers used a hookah during 2012, an increase from the 4.1% who admitted to using a hookah in 2011. 2.8% of high schoolers said they used an e-cigarette in 2012, upfrom just 1.5% in 2011. Middle school students are also being affected, with 1.1% saying they used an e-cigarette in 2012, nearly double the 0.6% who said the same in 2011.

The CDC issued concerns about rising teen use of tobacco products, though it did not specifically address the rise in e-cigarette use. E-cigarettes use a nicotine solution that is heated and then inhaled as a vapor, rather than burned tobacco.

“This report raises a red flag about newer tobacco products,” said Dr. Tom Frieden, director of the CDC. “Cigars and hookah tobacco are smoked tobacco – addictive and deadly. We need effective action to protect our kids from addiction to nicotine.”

The CDC believes the rise in emerging tobacco product use among teens could be related to a recent increase in marketing for those products, which is not currently regulated by the U.S. Food and Drug Administration (FDA). It also stated that increased use of e-cigarettes could be due to the perception of the products as safe alternatives to traditional cigarettes.

The CDC is recommending that emerging tobacco products be regulated in the same ways more traditional tobacco products currently are.

“A large portion of kids who use tobacco are smoking products other than cigarettes, including cigars and hookahs, which are similarly dangerous,” said Dr. Tim McAfee, director of the Office on Smoking and Health at the CDC. “As we close in on the 50th anniversary of the first Surgeon General’s report on the dangers of smoking, we need to apply the same strategies that work to prevent and reduce cigarette use among our youth to these new and emerging products.”