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People who smoke both cigarettes and cigars are more likely to be young, African American, male, unemployed and have less education compared with cigarette-only smokers, according to a new study. An estimated 12.5 percent of cigarette smokers also smoke cigars, UPI reports.

“While this data is disturbing, it is not surprising,” Amanda Richardson, Director for Research and Evaluation at Legacy, the public health organization that conducted the research, said in a statement. “Previous research has shown that cigars and cigarillos are already on the rise among young adults, especially as lower prices and sweet flavors may add to their appeal. In addition, minority and underserved populations that are most at-risk for dual use are those same populations that often bear a disproportionate brunt of tobacco-related morbidity and mortality.”

Legacy notes African-American males have higher rates of lung cancer, even though they tend to smoke fewer cigarettes per day than other groups. Those with less than a high school education have higher smoking rates and lower smoking cessation rates compared with smokers with a high school degree or higher.

According to Legacy, cigars can be as harmful as cigarettes. They can contribute to cancers of the mouth, lung, esophagus, and larynx, and may contribute to the development of chronic obstructive pulmonary disease.

Smokers of both cigars and cigarettes are more likely than those who only smoke cigarettes to have used at least one other tobacco product, such as snus, e-cigarettes, dissolvable tobacco or chewing tobacco. Richardson said that smoking cessation interventions may be less successful in people who smoke both cigars and cigarettes since their doctors might underestimate their overall tobacco use.

The study was published in the journal Nicotine and Tobacco Research.

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