The number of high school students who tried e-cigarettes tripled in one year — to more than 13 per cent. Water pipes or hookahs were used by 9.4 per cent.
But smoking of traditional cigarettes plummeted to 9.2 per cent from more than 13 per cent. That means smoking in high school is now less common than e-cigarette or hookah use.
The decline in cigarette smoking "is very dramatic and very encouraging," said Robin Koval, president of Legacy, an anti-smoking organization.
The report released Thursday by the Centers for Disease Control and Prevention mirrors the results of another government-funded study issued in December.
The CDC report is based on a national survey of about 22,000 students at middle schools and high schools, both public and private. Similar trends were found for middle school but at lower levels of use.
Students were asked whether they had smoked or used a tobacco product in the previous 30 days; those who said yes were deemed current smokers
Besides cigarettes, the report found continuing declines in the use of cigars, chewing tobacco and snuff among high school students.
CDC Director Dr. Tom Frieden this week described the findings as "alarming." He said the decline in use of most tobacco products was more than offset by the growth in nicotine-laden e-cigarettes and hookahs.
Some public health experts say the CDC is taking an unusually hard stand against e-cigarettes, at a time when scientists still trying to determine how harmful they are. They started selling in the U.S. in 2006 and are often described as a less dangerous alternative to cigarettes.
"The CDC has been very one-sided on the e-cigarette issue," said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.
E-cigarettes are battery-powered devices that produce an odourlessvapour that typically contains nicotine and flavourings.
Scientists say nicotine is harmful for the developing brain. Frieden said e-cigarettes are a new way of introducing kids to nicotine — and potentially hooking them on tobacco products in the future.
"The idea that kids are better off using e-cigarettes is just the wrong way of thinking about it," he said.
A year ago, the Food and Drug Administration proposed regulating e-cigarettes, including banning sales to minors. A final rule is expected by June, an FDA spokesman said Thursday.
Others were more positive about the new report and the drop in traditional cigarettes, and voiced more uncertainty about the science around e-cigarettes. There's not yet a scientific consensus on whether kids who try e-cigarettes go on to become regular smokers, Koval said.
"Is this a gateway in? Or a pathway out? We don't know," she said.
Warner said it's also not clear how many of those deemed users of e-cigarettes in the survey tried them once and didn't use them again.
"Is it a fad? Or will it stick around and come back to haunt us? We really don't know the implications of this in the long run," he said.
CDC report: http://www.cdc.gov/mmwr