Two of every five young smokers are using flavored cigarettes or little cigars, according to a report released from the Centers for Disease Control and Prevention on Tuesday.

 The study was the first of its kind to measure whether middle school and high school students are using flavored tobacco. The results were published in the Journal of Adolescent Health.

 “Flavored or not, cigars cause cancer, heart disease, lung disease, and many other health problems. Flavored little cigars appeal to youth and the use of these tobacco products may lead to disfigurement, disability, and premature death,” CDC Director Tom Frieden, MD, MPH, said in a news release. ”We need to take comprehensive steps to reduce all tobacco use for all of our youth.”

The study used data from the 2011 National Youth Tobacco Survey, an anonymous questionnaire presented to students in grades six through 12.

 Researchers found that more than 35 percent of youth cigarette smokers reported using flavored cigarettes, which could include menthol cigarettes or flavored little cigars that students mistook for flavored cigarettes.

 When asked, “Are you seriously thinking about quitting the use of all tobacco?” nearly 60 percent of respondents using flavored little cigars indicated they had no intention to stop. For those using unflavored little cigars, the figure was slightly less than 50 percent.

Public health officials say adding flavors to tobacco increases the appeal to children and teens, while tobacco companies say their products are all marketed to adults. The minimum age to buy tobacco in most states is 18.

 “Little cigars contain the same toxic and cancer-causing ingredients found in cigarettes and are not a safe alternative to cigarettes,” said Tim McAfee, MD, MPH, director of the CDC’s Office on Smoking and Health. “Many flavored little cigars appear virtually indistinguishable from cigarettes with similar sizes, shapes, filters, and packaging.”

In addition to offering a wide variety of flavors that appeal to young people, little cigars are taxed at a lower rate than cigarettes at the state level, according to the CDC.  The product has become more popular in recent years, with sales increasing 240 percent from 1997 to 2007. Flavored brands make up almost 80 percent of the market share.