E-cigarette use among teens has risen dramatically in the past year, according to the annual Monitoring the Future survey.

Increases in teen vaping from 2017 to 2018 were the largest ever recorded in the past 43 years for any teen substance use in the United States, the survey found. The percentage of 12th grade students who reported vaping nicotine in the past 30 days almost doubled—from 11 percent to 21 percent.

Teens’ use of other illicit drugs was flat or decreased, USA Today reports. The percentage of 12th grade students who misused a prescription opioid in the last 12 months declined to 3.4 percent in 2018—almost two-thirds lower than the peak of 9.5 percent recorded in 2004. Binge drinking significantly declined in 2018 among 12th grade students by 2.8 percentage points, to 14 percent.