People who smoke and/or abuse drugs are more likely to become frequent visitors of emergency rooms than non-smokers and those who don't abuse drugs, according to a recent study.

Researchers at the University of Buffalo found that smokers are four times more likely than non-smokers to become a frequent emergency room user. Similar to smoking's effect, substance abuse and psychiatric illnesses tripled a patient's likelihood of visiting the emergency room three or more times a year.

"There are a few super-users who have been in the ER 40 or 50 times, but when we step back and look at the whole population, we see a different pattern," Jessica Castner, assistant professor in the UB School of Nursing, said in a statement. "People aren't replacing their doctor; they are sicker, have more chronic diseases and are using everything more."

For the study, researchers collected and analyzed Department of Health data from 2009 of 56,000 people between the ages of 18-64 who used Medicaid to cover their medical expenses.

Patients were divided into four categories: healthy; at risk for chronic disease; diagnosed with chronic disease; and diagnosed with a system failure, such as kidney or heart failure.

Initially, researchers sought to shed light on whether patients are replacing visits to their primary care physicians with trips to hospital emergency rooms. They found that people with chronic diseases use both services equally and that, overall, medical care visits have soared in recent years.

"Emergency department use could increase as more individuals gain health insurance coverage under the Affordable Care Act, placing a financial strain on health insurers, patients and the overall health care system," Castner said in the study.

Future studies will reanalyze emergency department use with focuses on specific chronic conditions.

The findings are detailed in the journal Nursing Research.