WASHINGTON, D.C. – Yesterday, the U.S. Surgeon General said the soaring electronic cigarette usage among young adults is “a major public health concern,” the Washington Post reports. While Vivek Murthy indicated more research is needed, the government should restrict youth from using the product.

“We know enough right now to say that youth and young adults should not be using e-cigarettes or any other tobacco product, for that matter,” Murthy said. “The key bottom line here is that the science tells us the use of nicotine-containing products by youth, including e-cigarettes, is unsafe.”

Use of e-cigs has skyrocketed among U.S. young people to become the most commonly used form of tobacco in 2014. Since 2011, the number of middle school and high school students using e-cigarettes has grown threefold. Among those between the ages of 18 and 24, usage has doubled.

As an industry, electronic cigarette makers, while in favor of minimum age requirements, have insisted that they have not and do not market to minors. However, public health advocates have found some do go after the youth market with bubble gum and piña colada flavors, as well as aggressive marketing campaigns.

“In order to address tobacco in America, we need a multipronged approach,” Murthy said. “What’s at stake here is really protecting the next generation from nicotine addiction and tobacco-related disease.”

In 2014, NACS issued a statement of position that encourages stores selling e-cigarettes to adopt, as a best practice, a policy of treating these products as age-restricted and subjecting them to the same age-verification procedures as those applicable to tobacco products.