The first lady joined a chorus of officials voicing concern over the rampant use of e-cigarette products among the nation’s youth when she posted a tweet on Monday calling for more prevention and protection against nicotine addiction.

“I am deeply concerned about the growing epidemic of e-cigarette use in our children,” she wrote Monday. “We need to do all we can to protect the public from tobacco-related disease and death, and prevent e-cigarettes from becoming an on-ramp to nicotine addiction for a generation of youth.”

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The tweet ended with a mention of the Department of Health and Human Services, and quickly gained thousands of likes and retweets. Her call for action comes just days after health officials urged people to stop vaping until they can figure out why hundreds have been diagnosed with serious lung illnesses.

Officials have identified about 450 possible cases of illnesses, including at least five deaths in 33 states. They’ve yet to identify a single vaping device, liquid or ingredient common among all patients, but many involved THC.

Many of the cases involve teens, some of whom have come forward to describe their illnesses and subsequent hospitalizations in a bid to decrease use among their peers. A Snapchat user identified as Hunter Sims sent a warning from what appeared to be his hospital bed. A friend took a screenshot and posted it to his own Twitter account.

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Sims started his warning simply by writing “VAPING IS DANGEROUS,” before going on to explain that he used vapes and has been hospitalized with no improvement for five days despite various medications.

“My lung capacity is one mouthful,” Sims claimed in the Snap. “I can’t turn to the side in bed without having a bad respiratory attack, I literally have CDC members taking notes on me and the girl in the room next to me (she’s also in critical condition). There are doctors saying I might need a medically induced coma. The doctors don’t even know quite how to treat, or if we’ll survive. So trust me when I say it’s not worth it.”

Another teen in Utah said she will “never touch a vape again” after she was placed in a medically induced coma, with her family unsure if she would ever recover. She has since been released from the hospital but said she is still dealing with pain in her lungs and shortened breath.

In Alabama, educators in one district went so far as to remove the doors on bathroom stalls to prevent students from bringing banned e-cigarettes into schools after finding one student passed out in the bathroom two weeks ago.

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E-cigarettes do have potential to help adult and non-pregnant women quit smoking, but they are not safe for youth, young adults, pregnant women or adults who do not currently use tobacco products, according to the Centers for Disease Control and Prevention (CDC). The agency notes that scientists still have a lot to learn about whether e-cigarettes are effective for quitting smoking, and that additional research is needed to understand long-term health effects.