Half of all U.S. children live in a house where a parent or other adult uses tobacco, drinks heavily or uses illegal drugs, according to a report released on Tuesday.

These adults are three times more likely to abuse their children and four times more likely to neglect them than parents who do not abuse alcohol or drugs or use tobacco, according to a report from Columbia University’s National Center on Addiction and Substance Abuse.

“Children of alcohol and drug abusers are at increased risk of accidents, injuries and academic failure. Such children are more likely to suffer conduct disorders, depression or anxiety, conditions that increase the risk children will smoke, drink and use drugs,” the center said in a statement.

The report is an analysis of the center’s own research as well as dozens of reports including US government surveys on families and health behavior and the Children’s Defense Fund, a nonprofit social welfare organization.

It found that 35.6 million U.S. children, about half of all children in the country, live in a home where a parent or other adult uses tobacco, drinks heavily or uses illicit drugs.

More than 37 percent of U.S. children live with an adult who uses tobacco, nearly 24 percent live with a binge or heavy drinker and 12.7 percent live in a household where a parent or other adult uses illicit drugs, the report found.

Several studies show that children exposed to household cigarette smoke have a higher risk of sudden infant death syndrome, Asthma and ear infections. They are more likely to have their tonsils or adenoids surgically removed and recent studies show they have a greater risk of cancer and Heart disease.

“If substance abusing parents are not concerned about what drugs, alcohol and tobacco are doing to themselves, they should be concerned about the ill effects they have on their children,” center Chairman Joseph Califano said.

“Children of substance abusing parents are much likelier to become substance abusers themselves,” he added.

“A child who gets through age 21 without smoking, using illegal drugs or abusing alcohol is virtually certain never to do so.”