Vaping has surpassed smoking among adolescents in Europe, according to a new report by the World Health Organization.

The global health body found that among 15-year-olds, 32 percent had used an e-cigarette and 20 percent consumed vaping products in the past 30 days.

“The widespread use of harmful substances among children in many countries across the European region—and beyond—is a serious public health threat,” said Hans Henri P. Kluge, WHO regional director for Europe. “Considering that the brain continues to develop well into a person’s mid-20s, adolescents need to be protected from the effects of toxic and dangerous products. Unfortunately, children today are constantly exposed to targeted online marketing of harmful products.”

Historically, there has been a difference between boys and girls, with more boys smoking than girls. With e-cigarettes, girls reach the same level of use by 15 as boys and even outpace them after 15.

While acknowledging that some health authorities view e-cigarettes as a positive alternative to smoking for adults, the WHO expressed concern about aggressive targeting by manufacturers of a younger market, which has contributed to a particularly sharp rise in consumption between the ages of 13 and 15, according to the organization.

The WHO report calls for e-cigarettes to be incorporated into smoke-free policies, with similar measures to restrict marketing, reduce toxicity, remove flavors and increase taxation.

The health body has already called for e-cigarettes to be made available only to those who are trying to quit smoking, where other proven cessation strategies have been exhausted. It has also called for e-cigarettes to be regulated like medicines rather than being sold as consumer products.