In a new report on smoking cessation, the U.S. Surgeon General says 40% of smokers are not routinely counseled by their physicians to quit.

In an interview with The New York Times, Surgeon General Dr. Jerome Adams said, “That was a shocking statistic to me, and it’s a little embarrassing as a health professional.” He added, “The biggest take-home from this report is that far too many people who want to quit aren’t getting access to the cessation treatments that we know work.”

The report urges smokers to use smoking cessation methods that have been proven effective, and cautions that e-cigarettes are not among them. Dr. Adams acknowledged some people have found e-cigarettes to be helpful in quitting smoking. “We’ve heard powerful accounts from adults out there who tell us that they’ve used e-cigarettes to successfully transition from combustible cigarettes,” he said.