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People who abuse substances are more likely to be stigmatized than those who smoke or are obese, a new study suggests.

The study of 161 adults presented participants with six fictitious scenarios about people who either abused substances, smoked or were obese, according to HealthDay. “Specifically, participants rated their willingness for the individual in the fictitious scenario to marry into their family, be friends, socialize, work on a job, be a neighbor, and have one’s child date,” study author Lindsay Phillips of Albright College in Reading, Pennsylvania, said in a college news release.

She found people who were actively using substances were the most highly stigmatized group. The study found even people who formerly abused substances still face high levels of stigma. Phillips said this was troubling, because previous research has suggested stigma can discourage people from seeking help for substance abuse, and make them believe they cannot change their ways.

The findings are published in the Journal of Substance Use.

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