There was no change in overall tobacco use in middle and high school students between 2011 and 2014, according to the results of the 2014 National Youth Tobacco Survey; however, the use of hookah and e-cigarettes went up significantly. Co-conducted by the U.S. Centers for Disease Control and Prevention and the Food and Drug Administration, the survey found that in 2014, 24.6 percent (24.2 in 2011) of high school students reported using a tobacco product, while 12.7 percent (12.5 in 2011) reported current use of two or more products. E-cigarettes were the most popular tobacco product in both middle and high school, with 3.9 percent use and 13.4 percent use, respectively. Compared to 2011, e-cigarette use in high school students is up 11.9 percent, with hookah use increasing from 4.1 percent to 9.4 percent between 2011 and 2014. "Tobacco-related products have continued to evolve at a pace faster than our scientific understanding of their biological effects," stated Pamela B. Morris, MD, FACC, chair of ACC’s Prevention of Cardiovascular Disease Section Leadership Council, in response to the survey results. "Despite claims of potential health benefits, the long-term consequences of adolescent exposure to electronic cigarette aerosol, which contains nicotine, carbonyls (formaldehyde and acrolein) and particulates, are unknown." Read more.