On Monday, the American Academy of Pediatrics recommended raising the minimum age to purchase tobacco products—including e-cigarettes—to 21 nationwide as a way to protect the nation’s youth from “the pernicious effects of tobacco and nicotine.”

The group came down especially hard on e-cigarettes since their use among teens is now higher than any other tobacco product. In 2014, 13.4% of high school students said they had used e-cigarettes in the previous months, up from 1.5% in 2011, according to the Centers for Disease Control and Prevention. E-cigarette use among teens is especially concerning to the AAP since it’s associated with a higher likelihood of using regular tobacco and lower smoking cessation.

As a result, the AAP wants the Food and Drug Administration to regulate e-cigarettes in the same way it does other tobacco products with age restrictions, taxes, and bans on youth advertising and flavored products that are especially attractive to adolescents. It also recommends that smoke-free laws be expanded to include e-cigarettes because “aerosol emitted from e-cigarettes is not harmless; it contains a variety of toxic chemicals, including some carcinogens and significant amounts of nicotine.”

Most states don’t tax e-cigarettes as heavily as regular cigarettes, according to a Pew report earlier this year. And a report from the CDC in late 2014 found that more than 16 million children age 17 and under live in and 10 states and the District of Columbia where restrictions are so lax they can buy e-cigarettes legally.

In April 2014, the FDA proposed rules that would redefine e-cigarettes as tobacco products, ban the sale of nicotine-vapor dispensers to minors, and require e-cig manufacturers to print nicotine warnings on their packaging. Just last week the proposed rules were sent to the White House’s Office of Management and Budget, which has 90 days to review it.