One-fifth of U.S. adults — 50.6 million people — used tobacco products in 2019, according to a new government report.

According to AP, 14% of adults smoked cigarettes, while 4.5% used e-cigarettes. The highest prevalence of e-cigarette use was among young adult smokers, ages 18 to 24. The report noted 9.3% of young adults said they vaped last year. More than half of these young adults said they had never smoked cigarettes. The findings come from a survey of 32,000 people.

In a news release about the report, Robert R. Redfield, M.D., Director of the Centers for Disease Control and Prevention, said, “The battle against tobacco use in this country is far from over. Tobacco use remains the leading cause of preventable disease and death in the United States.”