U.S. health officials say teenage use of e-cigarette has reached “epidemic” levels and are calling on the industry to address the problem or risk having their flavored products pulled off the market.

The warning from the Food and Drug Administration on Wednesday marks a stark shift in the agency’s tone on e-cigarettes, which have become the most used tobacco product among teenagers.

Since 2017, FDA officials have discussed e-cigarettes as a potential tool to ween adult smokers off cigarettes.

But FDA commissioner Scott Gottlieb says the agency did not predict an “epidemic of addiction” among youth, mainly driven by flavored products.

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