A new large-scale study may have uncovered the need to treat smoking, substance use disorders, and mental health problems together. 

Published in the journal Drug and Alcohol Dependence, the study looked at data on more than 441,000 US adults collected over the course of 11 years. While all adults experienced an increase in serious psychological distress throughout that time, those who smoked daily and had a substance use disorder experienced the highest uptick in distress.

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