For middle and high school students, increased exposure to advertising for e-cigarettes parallels the increased use of the devices by kids, according to a new “Vital Signs” report from the Centers for Disease Control and Prevention.

“It’s no coincidence. Advertising works," CDC Director Dr. Tom Frieden told Fox News. "And when kids see ads — and they see them on the Internet, they see them on TV and in magazines and in stores — they’re more likely to use e-cigarettes. And that’s a problem.”

According to federal health officials, spending on e-cigarette advertising has increased from $6.4 million in 2011 to $115 million in 2014. During that same time period, e-cigarette use increased from 0.6 to 3.9 percent among middle school students, and from 1.5 to 13.4 percent among high school students.

E-cigarettes have become the most commonly used tobacco product among youth, while their use of conventional cigarettes has decreased.

“People need to understand that e-cigarettes are tobacco products,” Frieden said. “They contain nicotine. They’re addictive. And they may well result in changes in the adolescent brain and increase the chances that a kid will smoke regular cigarettes and have to deal with all of the suffering and disability and cost that that causes for a lifetime.”

Federal health officials see e-cigarettes as a potential gateway to conventional cigarette use. However, many e-cigarette advocates tout the smokeless devices as an exit door for smokers who want to quit.

“While experimentation with vaping by teens has risen over the past five years, over the same time period youth smoking experienced dramatic declines never before seen in America,” Gregory Conley, president of the American Vaping Association, an advocacy organization that receives funding from the e-cigarette industry, told Fox News via email. “It is illogical to suggest that the advertising of these smoke-free products will somehow lead youth to later take up smoking tobacco cigarettes.”

Cigarette smoking rates among middle school students dropped from 4.3 percent in 2011 to 2.5 percent in 2014, according to the CDC. During the same period, cigarette smoking rates among high school students declined from 15.8 percent to 9.2 percent.

Public health officials, the tobacco industry and e-cigarette consumers continue to debate whether the devices help in the reduction of conventional cigarette smoking, or merely create an additional product for delivering addictive nicotine.

“For adults, if you smoke regular cigarettes and you completely switch to e-cigarettes, that is going to be healthier for you,” Frieden said. “But if you then relapse to using conventional cigarettes… if, like three out of four adults who use e-cigarettes, you’re continuing to smoke — you’re not going to see that health benefit. But whatever you think about e-cigarettes in adults, in kids the message is clear: Kids should not be using e-cigarettes.”

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Although the U.S. Food and Drug Administration (FDA) has yet to gain authority to regulate e-cigarettes, states and municipalities are able to pass their own regulations to prohibit or discourage sales to minors.

Some initiatives have included restrictions on where e-cigarettes can be sold, age verification requirements and taxes to drive up the cost of tobacco products.