A photograph of what appeared to be her smoking a suspicious hand-rolled cigarette was uploaded on Instagram back in February.
And on Saturday, the star sparked concerns once again when she was pictured enjoying what appeared to be the same on her hotel balcony.
The 20-year-old singer was seen inhaling and puffing smoke into the air as she sat outside at her accommodation in Miami, Florida with the brown paper coated item.
What is she smoking? Miley Cyrus took a drag of a suspicious looking hand-rolled cigarette on her hotel balcony in Miami, Florida
Miley chatted to friends as they relaxed on a veranda, looking as though she had just woken up as she donned only a black T-shirt with gold writing across.
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The star, who had tied her short pixie blonde hair up on top of her head, squinted her eyes as she took a deep drag of the cigarette with her left hand, which was missing the engagement ring given to her by fiancé Liam Hemsworth.
Afterwards she laughed to herself as she peered down at the action below her.