How is this substance affecting my health specifically?
Six Pillars
Avoidance of risky substances
Make choices that reduce health risks
Tobacco, excessive alcohol use, and other harmful substances can affect your health in many ways. Reducing or avoiding these substances can lower health risks and support your overall well-being. If you’re thinking about making a change, your clinician can help you understand your options and find the right support.
Why it matters
This pillar focuses on reducing or avoiding substances that can negatively impact health, such as tobacco, excess alcohol, and other harmful substances.
Risky substances can affect:
What is true
Myth
Small amounts don’t really matter.
What’s true instead
Even moderate use can affect health—especially when combined with other risk factors.
Myth
If substance use hasn’t caused major problems, there’s no reason to change.
What’s true instead
You don’t have to hit a crisis point for a substance to affect your health. Reducing or eliminating substances that may be impacting your sleep, energy, mood, heart health, or overall well-being can provide meaningful benefits over time.
Four small starting actions
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Track your current use honestly for one week
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Identify one situation where use is most common
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Talk openly with your clinician about safe reduction strategies
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Choose one situation where you can replace use with a healthier alternative
Questions to ask your doctor
What level of use is safe for me?
What support options are available if I want to reduce or stop?
How will reducing use impact my medications or condition?
What should we monitor together as I make changes?
Avoidance of Risky Substances Pillar
A brief overview of how avoiding tobacco, excessive alcohol, and other harmful substances can protect health.
Best for: People who want to understand how substance use may affect their health and learn where to begin making changes.
Use with your clinician: Bring questions like, “How could my current substance use affect my health, and what support is available if I want to cut back or stop?” to your next visit.
Important: Be open with your healthcare team about substance use. If you regularly use alcohol, medications, or other substances, do not stop suddenly without appropriate medical guidance.
Avoiding Risky Substances During Pregnancy
Guidance on reducing exposure to substances that may affect health during pregnancy.
Best for: People who are pregnant, planning a pregnancy, breastfeeding, or supporting someone during pregnancy.
Use with your clinician: Bring questions like, “Are any of the substances, medications, or products I use unsafe during pregnancy or breastfeeding?” to your next visit.
Important: Discuss alcohol, tobacco, cannabis, supplements, prescription medications, and over-the-counter products with your prenatal care team. Do not discontinue prescribed medications without clinical guidance.
Family Guide to Avoiding Substances
Practical information to help families talk about risky substances and create a safer, more supportive home environment.
Best for: Parents, caregivers, and families who want to prevent substance use and support healthy decision-making.
Use with your clinician: Bring questions like, “How can I talk with my child about substances in an age-appropriate way, and what warning signs should I know?” to your next visit.
Important: Approach substance use concerns with calm, open communication. Seek professional help if substance use is affecting health, safety, relationships, school, or daily life.