A recent study analyzed smoking’s ties to substance use and mental, psychological and general health in sexual minority men and trans women.

Among sexual minority men and transgender women, smoking is associated with a higher rate of substance use as well as worse mental health.

That’s according to a new study conducted by researchers at the Rutgers School of Public Health that was published in the Annals of Behavioral Medicine.

The study’s authors surveyed a group of 665 racially, ethnically and socioeconomically diverse sexual minority men and trans women. Seventy percent of them reported smoking cigarettes.

Those who currently smoked were more likely to be white and reported marijuana use on a greater number of days during the past months compared with those who did not currently smoke cigarettes. Current smokers also had more symptoms of anxiety and used alcohol more frequently.

“Evidence also tells us that smoking is associated with worse mental health and increased substance use, but we don’t know how these conditions are related to each other, exacerbating and mutually reinforcing their effects,” Perry N. Halkitis, PhD, dean of the Rutgers School of Public Health and the study’s senior author, said in a press release.

“Our findings underscore the importance of holistic approaches to tobacco treatment that account for psychosocial drivers of substance use and that address the complex relationships between mental health and use of substances like alcohol, tobacco and marijuana,” said Caleb LoSchiavo, a doctoral student at the Rutgers School of Public Health and the study’s first author.

To read a press release about the study, click here.

To read the study abstract, click here.