People with behavioral health conditions are significantly more likely to have stressful living conditions than the general population. This helps explain why adults with mental illness and substance use disorders are twice as likely to smoke than adults without these disorders. To live up to our ideals of fairness, we need to make sure that everyone has access to the same resources, supports and protections, so every has a fair chance to be healthy. Cigarettes smoking and vaping are substantial risk factors for bacterial and viral infections including COVID-19.