Many teens who smoke also use alcohol, marijuana and other tobacco products, a new study finds. Researchers at the University of California, San Diego studied 176 teen smokers and found 96 percent said they used at least two other substances besides cigarettes, HealthDay reports.

The study found 16 percent of teen smokers said they used harder drugs, such as Ecstasy, cocaine or hallucinogens, or they misused prescription drugs.

Most of the teens in the study smoked five or fewer cigarettes a day. “This tells us that multidrug use among adolescents may be more prevalent than we think, and that even kids who smoke only occasionally are likely to be doing other drugs,” said lead researcher Karma McKelvey.

The findings appear in the journal Addictive Behaviors.