Alcohol consumption and tobacco use are closely linked behaviors, with high-risk alcohol consumption, psychological distress, and current smoking significantly associated with increased emergency department visits. This retrospective study analyzed 200 patients treated for tobacco- and alcohol-induced psychological distress at a tertiary care hospital. The highest incidence of emergency presentations was among those aged 41-50 years, with males (96%) being the dominant demographic. Smoking prevalence was 3%, with 5% using smokeless tobacco, while alcohol use was noted in 12% of patients. Comorbidities were present in 50% of patients, including hypertension (17%), type 2 diabetes (7.5%), and chronic obstructive pulmonary disease (1%). The study utilized the FAST and AUDIT scales to assess psychological distress related to alcohol use, finding 129 patients with possible dependence, 21 with increased risk, and 29 with lower risk. The K-10 scale revealed 129 patients with moderate risk and 55 with higher risk for psychological distress. The study highlights the interdependence of tobacco and alcohol use, leading to significant health and socio-economic consequences. Clinical pharmacists play a crucial role in mitigating these effects by providing counseling on withdrawal benefits, educating patients about dependence and available interventions, and referring them to rehabilitation centers. Monitoring prescriptions for drug interactions and updating physicians on recent interventions are also key responsibilities. By offering counseling sessions to patients and their families, clinical pharmacists can enhance patient quality of life and reduce morbidity and mortality associated with these social behaviors.