About 4.6 million middle and high school students were users of a tobacco product in 2014, the Centers and Disease Control and Prevention says.
About 70 percent of those students, the Center says, used at least one flavored tobacco product.
"There is growing concern that widely marketed varieties of new and existing flavored tobacco products might appeal to youths and could be contributing to recent increases in the use of tobacco products," the CDC says.
The CDC and the Food and Drug Administration analyzed data from the 2014 National Youth Tobacco Survey to determine how frequently middle school and high school students used cigarettes, e-cigarettes, cigars, and smokeless tobacco products.
About 22,000 students at more than 200 schools took part in the 2014 survey.
Among high school students who used tobacco at least once in the previous 30 days, frequent use (20 or more days in the previous 30) was most prevalent among smokeless tobacco users (42.0 percent), followed by cigarette smokers (31.6 percent), e-cigarette users (15.5% percent, and cigar smokers (13.1 percent).
About 2.2. million of those students used two or more types of tobacco products, which the CDC says leads to increased symptoms of nicotine dependence.
"The increased use of emerging tobacco products, such as e-cigarettes and hookahs, and the use of multiple types of tobacco products, is a public health concern.," the CDC says. "Greater understanding of the types of tobacco products and patterns of use of these products among youths is important for ensuring that proven tobacco prevention and control strategies...address the diverse types of tobacco products used by youth."
In addition, the CDC estimated, 1.58 million had used a flavored e-cigarette, 1.02 million had used flavored hookah tobacco, 910,000 had used a flavored cigar, 690,000 had used flavored smokeless tobacco, 900,000 had used menthol cigarettes, and 120,000 had used flavored tobacco in pipes.
"Flavored tobacco products are enticing a new generation of America’s youth into nicotine addiction, condemning many of them to tobacco-related disease and early death,” says CDC Director Tom Frieden.