Almost one in 12 high school seniors smoke small, sweet-flavored cigars, according to a new study by the Centers for Disease Control and Prevention (CDC).

The findings, based on a survey of nearly 19,000 students in grades 6 through 12, are published in the Journal of Adolescent Health. The CDC researchers found that when they also asked about menthol-flavored cigarettes, more than 40 percent of teens who were current smokers said they used flavored cigars or cigarettes.

The cigars are flavored to taste like candy or fruit, the Associated Press reports. They come in flavors including peach, strawberry, chocolate, grape and blueberry. Cigarettes with candy, fruit or clove flavoring have been banned since 2009, the article notes. There are no restrictions on cigars with these flavorings, except in Maryland, Maine, New York City and Providence, Rhode Island.

Health officials are concerned about small cigars because the sweet flavoring can make them more appealing to young people. “The so-called small cigars look like cigarettes, addict as much as cigarettes and they kill like cigarettes,” CDC Director Dr. Tom Frieden told the AP.

“The tobacco industry has a long history of using flavored products to attract kids,” said Danny McGoldrick of the Campaign for Tobacco-Free Kids. His group released a report earlier this year that stated, “Cheap, flavored, small cigars that appeal to young people are marketed aggressively and have resulted in high school kids and young adults being twice as likely as their older counterparts to be cigar smokers.”

According to the Campaign for Tobacco-Free Kids, cigar smoke contains the same toxins as cigarette smoke. “Any difference in risks between cigars and cigarettes is likely attributable to differences in frequency of use and the fact that not all cigar smokers inhale,” the group notes in its report. “However, many new cigar products are more like cigarettes and therefore are more easily smoked and inhaled like cigarettes.”