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Smokers who don't like going to the doctor pay attention: new research reveals that smokers four times more likely than non-smokers to end of the the emergency room. 

Lead researcher Jessica Castner, of the University at Buffalo, analyzed Department of Health data from 2009 of 56,000 people between the ages of 18 and 64 who used Medicaid to cover their medical expenses.

Participants were categorized into four different groups: healthy; at risk for chronic disease; diagnosed with chronic disease; and diagnosed with a system failure. 

The findings revealed that smokers were just like patients diagnosed with chronic diseases when it comes to ER visits. 

"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," explained Castner, assistant professor in the UB School of Nursing. "People aren't replacing their doctor; they are sicker, have more chronic diseases and are using everything more."

The findings revealed that like chronic disease- smoking, drug abuse and mental illness tripled a patients risk of becoming "frequent ER user". Researchers defined frequent ER users as those who visited the ER more than three times a year.

The findings were published in the journal Nursing Research.