Every May 31, the World Health Organization sponsors No Tobacco Day to highlight what public health officials say is a growing epidemic of smoking worldwide. This year's theme is "Tobacco: Deadly in Any Form or Disguise," to bring attention to use of non-cigarette forms of tobacco use.

The WHO estimates that smoking accounts for one in 10 premature deaths. Experts say it is the second leading form of death after malaria.

Its officials say nearly five million people die prematurely every year due to tobacco-related illnesses. If the trend continues, the number will be 10 million by the year 2020.

To coincide with No Tobacco Day, the U.S. Centers for Disease Control in Atlanta, Georgia released an international survey of teenage smoking habits in 132 countries and the Gaza strip.

The study found that nearly two in 10 youngsters between the ages of 13 and 15 report using cigarettes, although boys were still significantly more likely than girls to smoke.

But unlike their previous survey, lead investigator Charles Warren of the CDC's Office of Smoking and Health says a similar number of males and females reported using non-cigarette products.

"So it highlights the need for tobacco control programs to focus on the broad use of tobacco not just cigarettes," said Charles Warren.

For the first time, the survey also included data from the Kurdish region of Iraq.

While investigators found a huge gulf in cigarette use between males and females - 21 percent versus 2 percent - the use of tobacco products other than cigarettes was much narrower - 14 percent for boys compared to 10 percent for girls.

Warren says one factor may be the use of water pipes, or hookahs, which are used to smoke flavored tobacco or shisa. Warren says it's becoming a more common practice throughout the Middle East.

"It's changing from the old days where primarily older males would go to the cafes," he said. "Now, apparently families are going to the cafes where the hookah pipes are and the young people are participating and it's a cultural change and apparently it's kind of OK to do this."

Warren says few studies have been done on the health affects of hookahs. Those that have suggest the habit may be more dangerous than cigarette smoking because hookah smokers may inhale 10 times more smoke than cigarette smokers.

Other popular but equally dangerous smoking products are bidis, which are thin cigarettes made of cheap tobacco that are mixed with strong flavorings to hide their bitter taste. And kreteks, which are clove-flavored cigarettes from Indonesia.

Bidis and kreteks in particular are thought to contain higher concentrations of tar, nicotine and carbon monoxide than conventional cigarettes sold in the U.S.

Experts say people shouldn't be lulled into thinking they can switch to a safe tobacco product, including light cigarettes.

They say a light cigarette that boasts less tar and nicotine is just as dangerous as a regular cigarette. And the same goes for other tobacco products.

A separate WHO report entitled Tobacco: Deadly in Any Form or Disguise focuses on non-traditional cigarettes and tobacco products.

Lead author Jack Henningfield says people are getting the message that cigarettes are deadly and addictive.

"And so a lot of people are turning to other products that they think are safer," said Jack Henningfield. "And these include the water pipes, the chewing tobacco, snuff, and cigars - all kinds of products. And these are all kinds of deadly and addictive products. It's kind of like trying to deal with the fire with gasoline."

Henningfield says tobacco is the second biggest killer around the world after malaria. But unlike malaria, tobacco-related deaths are entirely preventable.

"Quit if you are using," he said. "Not start any product if you are not using. And that is one of the most important things to improve health in America and health around the world."