Electronic cigarette use by teenagers has doubled since 2011. Health experts say the devices are being marketed to youths, putting them at risk for addiction to nicotine and regular cigarettes. One out of 10 American high school students used electronic cigarettes in 2012, along with nearly 3% of middle school students, according to a new federal report. That's about double the rate of electronic cigarette use in 2011 and translates into 1. 78 million children and teens who have tried the battery powered devices. The sharp increase has public health experts worried.

Electronic cigarettes contain the addictive chemical nicotine and traces of cancer causing compounds called nitrosamines. The safety profile of the devices has not been fully studied, according to warnings from the Food and Drug Administration. In addition, electronic cigarettes are sold with cartridges that give them enticing flavors such as mint or chocolate, and health advocates fear they have the potential to turn teens on to regular cigarettes. "The increased use of electronic cigarettes by teens is deeply troubling," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said in a statement.

"Many teens who start with electronic cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes. ” The new study, published in Friday's edition of the CDC's Morbidity and Mortality Weekly Report, is based on data from the National Youth Tobacco Survey. It found that 1. 1% of students in grades 6 through 8 were using electronic cigarettes at least once a month, as were 2. 8% of students in grades 9 to 12. Among these regular electronic cigarette users, 76. 3% also smoked traditional cigarettes.

But the report's authors from the FDA's Center for Tobacco Products and the CDC's Office on Smoking And Health expressed particular concern about students who had used electronic cigarettes but had not yet tried conventional cigarettes. The researchers estimated that 160,000 students across the country fell into that category. "The risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products" among these students is a "serious concern," they wrote. Cigarette smoking is responsible for more than 440,000 deaths each year, including 49,400 due to secondhand smoke, according to the CDC.

Tobacco use is the No. 1 cause of preventable electronic cigarettes. "When you see cotton candy, bubble gum and atomic fireball flavors, there's no question these products are being marketed directly at kids," said Erika Sward, the group's vice president for national advocacy. "I think this data really shows our concerns are real. " Electronic cigarette manufacturers insist that they are not marketing the devices to minors.

Tom Kiklas, the chief financial officer of the Tobacco Vapor Electronic Cigarette Assn., said a federal appeals court ruled in 2010 that electronic cigarettes were not medical devices and should instead be considered tobacco products. As such, their sale to minors is prohibited by law, and it's the responsibility of retailers to ensure that buyers are of legal age, he said. "Kids aren't supposed to be buying any tobacco product," Kiklas said. The American Thoracic Society, like the American Lung Assn. , has criticized electronic cigarette manufacturers for marketing their products as a means to help people quit smoking. "These products are not approved by the FDA as smoking cessation devices," said society spokesman Gary Ewart.

If the FDA intends to restrict access to electronic cigarettes before they take off with consumers, it's probably too late. One tobacco industry analyst from Wells Fargo Securities predicts Americans will spend $1. 7 billion on electronic cigarettes this year. That means public health authorities should get busy, according to the authors of the new study. "Given the rapid increase in use and youths' susceptibility to social and environmental influences to use tobacco, developing strategies to prevent marketing, sales, and use of electronic cigarettes among youths is critical," they wrote.